Ozawa Yasuaki, Imafuku Yuji, Nishi Sadataka, Yoshida Hiroshi
Department of Clinical Laboratory Medicine, Fukushima, Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1247, Japan.
Clin Chim Acta. 2004 Dec;350(1-2):189-93. doi: 10.1016/j.cccn.2004.07.010.
In chronic hemodialysis patients, hyperkalemia is frequently observed. In these patients, erythrocytes were examined to know whether they participate in the regulation of K(+) or not.
Erythrocyte K(+) release (DeltaKr) was induced by the incubation of erythrocyte suspension at 4 degrees C for 24 h and the K(+) influx followed at 37 degrees C for 3 h. K(+) flux of erythrocytes or DeltaKi/DeltaKr ratio, which was reflected by Na(+)/K(+)-exchanging ATPase, was measured in chronic hemodialysis patients. K(+) concentration was measured by ion-selective electrode method.
Non-diabetic hemodialysis patients classified into three groups according to their serum levels were compared for various factors. Among them, the DeltaKi/DeltaKr ratios in medium- and high-serum K(+) groups were significantly lower than those in the low serum K(+) group. The effect of hemodialysis on erythrocyte K(+) flux was examined. After hemodialysis, the mean DeltaKi/DeltaKr ratio increased significantly compared with that before the treatment. Erythrocyte K(+) concentrations converted into a narrower range after hemodialysis.
The reduced K(+) flux in erythrocyte may play a part in the development of hyperkalemia in non-diabetic chronic hemodialysis patients.
在慢性血液透析患者中，高钾血症较为常见。对这些患者的红细胞进行检测，以了解其是否参与钾离子（K⁺）的调节。
通过将红细胞悬液在4℃孵育24小时诱导红细胞K⁺释放（ΔKr），并在37℃追踪3小时的K⁺内流。在慢性血液透析患者中测量红细胞的K⁺通量或由钠钾交换ATP酶反映的ΔKi/ΔKr比值。采用离子选择电极法测量K⁺浓度。
根据血清水平将非糖尿病血液透析患者分为三组，并比较各种因素。其中，中、高血清钾组的ΔKi/ΔKr比值显著低于低血清钾组。研究了血液透析对红细胞K⁺通量的影响。血液透析后，平均ΔKi/ΔKr比值较治疗前显著升高。血液透析后红细胞K⁺浓度范围变窄。
红细胞中K⁺通量降低可能在非糖尿病慢性血液透析患者高钾血症的发生中起作用。
