Altered erythrocyte membrane protein composition in chronic kidney disease stage 5 patients under haemodialysis and recombinant human erythropoietin therapy.
Our aim was to evaluate red blood cell (RBC) membrane protein composition in chronic kidney disease (CKD) stage 5 patients under haemodialysis (HD) and recombinant human erythropoietin (rhEPO) therapy, and its linkage to rhEPO hyporesponsiveness. We evaluated in 63 CKD stage 5 patients (32 responders and 31 non-responders to rhEPO therapy) and in 26 healthy controls RBC count, haematocrit, haemoglobin concentration, haematimetric indices, reticulocyte count, reticulocyte production index, RBC osmotic fragility test and membrane protein analyses. CKD stage 5 patients presented significant changes in membrane protein composition, namely a reduction in spectrin, associated to altered protein 4.1/spectrin and spectrin/band 3 ratios. Non-responder CKD stage 5 patients were more anaemic, with more microcytic and anisocytic RBCs, than responders; significantly altered ankyrin/band 3 and spectrin/ankyrin ratios were also observed. CKD stage 5 patients under HD are associated with an altered protein membrane structure, which seems to the disease itself and/or to the interaction with HD membranes.
Costa
Elísio
E
Serviço de Bioquímica, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal.
Rocha
Susana
S
Rocha-Pereira
Petronila
P
Castro
Elisabeth
E
Miranda
Vasco
V
do Sameiro Faria
Maria
M
Loureiro
Alfredo
A
Quintanilha
Alexandre
A
Belo
Luís
L
Santos-Silva
Alice
A
D000368:Aged; D000740:Anemia / Q000097:blood* / Q000188:drug therapy / Q000209:etiology; D001457:Anion Exchange Protein 1, Erythrocyte / Q000032:analysis; D017487:Ankyrins / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis*; D000068256:Darbepoetin alfa; D003928:Diabetic Nephropathies / Q000097:blood / Q000628:therapy; D004351:Drug Resistance; D000068817:Epoetin Alfa; D004910:Erythrocyte Membrane / Q000737:chemistry*; D004921:Erythropoietin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D007501:Iron / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D008297:Male; D008565:Membrane Proteins / Q000097:blood*; D008567:Membranes, Artificial; D008875:Middle Aged; D010084:Oxidation-Reduction; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation; D013049:Spectrin / Q000032:analysis
C110202:ANK1 protein, human; D001457:Anion Exchange Protein 1, Erythrocyte; D017487:Ankyrins; D001798:Blood Proteins; D008565:Membrane Proteins; D008567:Membranes, Artificial; D011994:Recombinant Proteins; D004921:Erythropoietin; D013049:Spectrin; D000068256:Darbepoetin alfa; D000068817:Epoetin Alfa; D005492:Folic Acid; D007501:Iron