title: Influence of glucose in dialyzing fluid on purine concentrations in hemodialyzed patients with chronic renal failure.
abstract: BACKGROUND
  In chronic renal failure the accumulation of some purine nucleotides (in erythrocytes) develops both in patients undergoing conservative treatment and in hemodialyzed patients. The aim of the study was: (1) To find if hemodialysis (HD) sessions using dialyzing fluid containing glucose leads to an increase in ATP concentration and changes in the concentration of other nucleotides, nucleosides and oxypurines in erythrocytes. The potential consequence of such purine concentration changes is the increase of 2,3-DPG concentration and an improved transportation of oxygen in erythrocytes which are more resistant to hemolysis. (2) To compare blood concentrations of purine nucleotides, nucleosides and oxypurines in patients undergoing chronic HD with dialyzing fluid containing or lacking glucose. Significant differences could suggest the long-term influence of glucose in dialyzing fluid on erythrocyte energetic state.
  
  
  METHODS
  Whole blood nucleotide concentrations were evaluated with the use of a high-performance liquid chromatography technique.
  
  
  RESULTS
  Before the HD session the patients in the 'plus glucose' group had significantly higher concentrations of ATP, ADP, AMP, TAN, NAD, NADP, GTP + GDP, GMP, Urd and HYP than patients in the 'no glucose' group. After the HD the patients in the 'plus glucose' group had significantly higher concentrations of ADP, AMP, TAN, NAD, NADP, Urd and HYP than in the 'no glucose' group. Both before and after the HD session, the uric acid concentrations and AEC were significantly lower in the 'plus glucose' group than in the 'no glucose' group. A significant decrease in the whole blood hypoxanthine (p < 0.05) and uric acid (p < 0.001) concentrations after HD was found in the 'no glucose' group while a significant increase in ADP concentration (p < 0.05) was detected in the patients' erythrocytes in the 'plus glucose' group. In this group a significant decrease of GTP + GDP and GMP (p < 0.05), uric acid concentration (p < 0.001) and adenylate energy charge (p < 0.05) were observed after the dialysis. However, no significant differences in nucleotide concentrations before and after the HD were found in the 'no glucose' group.
  
  
  CONCLUSIONS
  The presence of glucose in the dialyzing fluid causes a significant modification of the energetic state of cells which is reflected by the purines' and their metabolites' concentrations in the erythrocytes. Higher ATP concentrations in patients with renal failure who have been dialyzed with the fluid containing glucose can be considered as an organism adaptation to a decreased amount of RBC and hemoglobin concentration.
authors.affiliation: Department of Biochemistry and Chemistry, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Bober
authors.forename: Karolina
authors.initials: K
authors.lastname: Kedzierska
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Safranow
authors.forename: Ewa
authors.initials: E
authors.lastname: Kwiatkowska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Jakubowska
authors.forename: Edyta
authors.initials: E
authors.lastname: Herdzik
authors.forename: Barbara
authors.initials: B
authors.lastname: Dołegowska
authors.forename: Leszek
authors.initials: L
authors.lastname: Domański
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Ciechanowski
mesh_terms: D019794:2,3-Diphosphoglycerate / Q000378:metabolism; D000255:Adenosine Triphosphate / Q000378:metabolism*; D000328:Adult; D000368:Aged; D015314:Dialysis Solutions; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000494:pharmacology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011684:Purine Nucleosides / Q000378:metabolism; D011685:Purine Nucleotides / Q000378:metabolism*; D011687:Purines / Q000378:metabolism; D006435:Renal Dialysis
chemical_list: D015314:Dialysis Solutions; D011684:Purine Nucleosides; D011685:Purine Nucleotides; D011687:Purines; D019794:2,3-Diphosphoglycerate; D000255:Adenosine Triphosphate; D005947:Glucose