[A study on hemolysis in hemodialysis patients].

In order to investigate the pathogenesis of hemolysis in chronic renal failure, red cell life span and hemolysis starting point (HSP) by coil planet centrifuge method were studied in 32 hemodialysis (HD) patients and 16 healthy subjects. Mean red cell life span was 22.0 days before recombinant human erythropoietin (r-HuEPO) therapy, and prolonged up to 28.1 days after r-HuEPO therapy. Mean HSP in HD patients was significantly elevated than healthy subjects. Mean HSP was 106.7 mOsm before r-HuEPO therapy, and improved to 101.0 mOsm after r-HuEPO therapy. HSP improved from 106.8 mOsm to 100.8 following the correction of bicarbonate level with HD. HSP was negatively correlated to bicarbonate level pre- and post-r-HuEPO therapy, but HSP was not correlated to BUN, serum creatinine, hydrogen ion, anion gap and amount of body water removal during HD. When blood PH in 18 HD patients was adjusted by 7% NaHCO3 from 7.21 to 7.40, HSP improved to normal range in all. These data suggested that osmotic fragility was normal in younger erythrocyte in HD patients, and a decrease of plasma bicarbonate level resulted in an increase of hemolysis.