title: Reduced Erythrocyte Survival in Uremic Patients Under Hemodialysis or Peritoneal Dialysis.
abstract: OBJECTIVE
  Recent observations in end-stage renal disease (ESRD)-patients on hemodialysis revealed that anemia is, in part, due to stimulated suicidal erythrocyte death or eryptosis leading to accelerated clearance of circulating erythrocytes. The present study explored whether eryptosis is similarly enhanced in patients on peritoneal dialysis (PD).
  
  
  METHODS
  Measurements were made in freshly drawn erythrocytes from healthy volunteers (n=38), and ESRD patients on hemodialysis (HD; n=18) or on PD (n=22). Both, HD patients and PD patients suffered from anemia despite increased reticulocyte numbers.
  
  
  RESULTS
  The percentage of phosphatidylserine-exposing erythrocytes was significantly higher in HD patients than in healthy volunteers and significantly higher in PD patients than in healthy volunteers and HD patients. In PD patients, the percentage of phosphatidylserine-exposing erythrocytes was positively correlated with dialysis volume. The increase in phosphatidylserine exposure was in both, HD and PD patients, paralleled by increase of reactive oxygen species and ceramide abundance. In both, HD and PD patients, a positive correlation was observed between the percentage of phosphatidylserine-exposing erythrocytes and both, erythropoietin dosage and the percentage of reticulocytes.
  
  
  CONCLUSIONS
  Similar to HD patients, PD patients suffer from enhanced eryptosis, which is paralleled by oxidative stress and enhanced ceramide abundance contributing to the anemia of uremic patients.
authors.affiliation: Institute of Cardiology, Vascular Medicine and Physiology, University of Tuebingen, Tuebingen, Germany.
authors.forename: Rosi
authors.initials: R
authors.lastname: Bissinger
authors.forename: Ferruh
authors.initials: F
authors.lastname: Artunc
authors.forename: Syed M
authors.initials: SM
authors.lastname: Qadri
authors.forename: Florian
authors.initials: F
authors.lastname: Lang
mesh_terms: D000328:Adult; D017209:Apoptosis; D016923:Cell Death; D002518:Ceramides; D004912:Erythrocytes / Q000473:pathology*; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010718:Phosphatidylserines / Q000378:metabolism; D017382:Reactive Oxygen Species; D006435:Renal Dialysis / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000097:blood / Q000628:therapy; D014511:Uremia / Q000097:blood*
chemical_list: D002518:Ceramides; C554270:EPO protein, human; D010718:Phosphatidylserines; D017382:Reactive Oxygen Species; D004921:Erythropoietin