The effect of biofiltration on red blood cells 2.3-diphosphoglycerate and pH.
To investigate the effect of biofiltration (BF) on the ability of blood to supply oxygen to the peripheral tissues, a 2 week crossover study was conducted with bicarbonate hemodialysis (BcHD) and BF using 5 male patients with diabetic renal failure as subjects. BcHD and BF were performed for 4 h and 3.5 h per session, respectively. Blood gases, the pH of red blood cells (RBC-pH), and 2. 3-diphosphoglycerate in RBC (RBC-2.3DPG) were measured during each treatment. After a 2 week BF treatment, the plasma HCO3- at the beginning of BF was significantly higher than that of BcHD (p < 0.01), and the blood pH improved with an elevated plasma bicarbonate level (p < 0.05). The RBC-pH at the beginning of BF was higher than that of BcHD (p < 0.05) although the RBC-pH at the end of both therapies increased to similar levels. The RBC-2.3DPG during BcHD remained unchanged, but during BF significantly increased (p < 0.05). Metabolic acidosis was significantly improved by BF with its effect reaching to the RBC intracellular level. The improved metabolic acidosis might occur as a result of the increase in RBC-2.3DPG during BF. This increase in RBC-2.3DPG has the effect of reducing the affinity of oxygen for hemoglobin and allows more oxygen to be delivered to the peripheral tissues although the increase in RBC-pH by dialysis restricts the dissociation of oxygen from hemoglobin.
Umimoto
K
K
Department of Clinical Engineering, Osaka Rosai Hospital, Sakai, Japan.
Hirai
Y
Y
Hayashi
T
T
Tanaka
H
H
D019794:2,3-Diphosphoglycerate / Q000097:blood*; D001639:Bicarbonates / Q000097:blood; D018592:Cross-Over Studies; D003928:Diabetic Nephropathies / Q000097:blood / Q000628:therapy; D004912:Erythrocytes / Q000737:chemistry*; D017583:Hemodiafiltration; D015312:Hemodialysis Solutions; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
D001639:Bicarbonates; D015312:Hemodialysis Solutions; D019794:2,3-Diphosphoglycerate