Sodium and potassium fluxes and concentrations in erythrocytes of normal subjects during prolonged sodium depletion and repletion.

The erythrocyte concentration and fluxes of sodium and potassium were investigated in normal white male subjects during dietary sodium restriction and repletion, each period lasting for 16 weeks. During dietary sodium restriction the intra-erythrocyte sodium concentration decreased and the red cell ouabain-sensitive 86Rb-uptake increased; no significant changes were observed in the ouabain-insensitive fluxes of sodium such as the total, frusemide-resistant and frusemide-sensitive Na+-efflux and the Na+, Li+-countertransport. The decrease in the intra-erythrocyte sodium concentration could result from an increased Na+,K+-ATPase pump activity. The latter increase could be secondary to the early decrease in a digitalis-like plasma inhibitor and the late increase could be facilitated by the late rise in the intracellular ATP concentration, which is the energy supplier for this pump. During the subsequent first month of sodium repletion the intra-erythrocyte sodium concentration remained low, the red cell ouabain-sensitive 86Rb-uptake and ATP concentration remained elevated and returned to baseline only after 16 weeks. This long-term effect suggests either the involvement of a mechanism which can only be slowly reversible or a mechanism which is irreversible so that normalization takes place only when new red cells are released into the circulation.