Bazzato G, Coli U, Landini S, Fracasso A, Righetto F, Scanferla F, Morachiello P
Int J Artif Organs. 1986 Dec;9 Suppl 3:35-8.
The kinetics of extra and intracellular red blood cell (RBC) Pi and its removal by different therapeutic modalities were evaluated in 30 uremic patients over a 6 mo. period. Acetate hemodialysis alone, combined with hemoperfusion, or associated once a week with plasma-perfusion sessions using an activated bauxite cartridge, bicarbonate dialysis either in single pass or in recirculating system (40 L) and biofiltration, were the depurative treatments employed. The treatments with acetate buffer showed a temporary intracellular shift of Pi at the end of the sessions with post-dialytic plasma Pi rebound. This was not evident with bicarbonate buffer and biofiltration where acidosis was corrected better, and similarly during plasma perfusion treatment because blood pH remained unchanged. These findings may explain the better plasma Pi level at the end of our study with these later therapeutic models compared to acetate dialysis alone or combined with hemoperfusion. In these conditions Pi removal is limited by the correction of acidosis which implies acetate metabolism with ATP activation leading to a transient Pi intracellular influx and a subsequent efflux into the extracellular compartment.
在6个月期间，对30名尿毒症患者评估了细胞内外红细胞（RBC）无机磷（Pi）的动力学及其通过不同治疗方式的清除情况。采用的净化治疗方法包括：单独的醋酸盐血液透析、联合血液灌流、或每周一次与使用活性铝土矿滤柱的血浆灌流治疗相结合、单通道或循环系统（40L）的碳酸氢盐透析以及生物滤过。使用醋酸盐缓冲液的治疗在治疗结束时显示Pi出现暂时的细胞内转移，透析后血浆Pi出现反弹。在碳酸氢盐缓冲液和生物滤过中这种情况不明显，因为酸中毒得到了更好的纠正，在血浆灌流治疗期间同样如此，因为血液pH值保持不变。这些发现可能解释了在我们的研究结束时，与单独的醋酸盐透析或联合血液灌流相比，使用这些后期治疗模式时血浆Pi水平更好的原因。在这些情况下，Pi的清除受到酸中毒纠正的限制，这意味着醋酸盐代谢与ATP激活，导致Pi暂时流入细胞内，随后又流入细胞外液。
