Cheng J T, Feinfeld D A, Briscoe A M, Nurse H M, Hotchkiss J L, Thomson G E
Am J Kidney Dis. 1987 Mar;9(3):211-6. doi: 10.1016/s0272-6386(87)80057-4.
Intracellular sodium and potassium concentrations were determined on erythrocytes obtained, before and after treatment, from patients with end-stage renal disease undergoing 48-hour intermittent peritoneal dialysis. Erythrocyte sodium increased from 7.5 +/- 0.3 to 8.6 +/- 0.4 mmol/L cells with a mean of 1.1 +/- 0.1 mmol/L cells (P less than .001), but erythrocyte potassium and cellular water content were virtually unchanged. Plasma potassium decreased during dialysis from 4.2 +/- 0.2 to 3.3 +/- 0.1 mEq/L (P less than .001). The increase in red-cell sodium correlated with this decrease in plasma potassium (r = .51, P less than .01). In contrast, erythrocyte sodium and potassium in undialyzed control patients with chronic renal failure did not change over a similar period, and plasma potassium was unchanged (4.3 +/- 0.1 mEq/L before and 4.3 +/- 0.2 mEq/L after 48 hours). Incubation of postdialysis erythrocytes from the dialysis patients in their own plasma at varying potassium concentrations showed that the rise in cell sodium was blunted as the plasma potassium was increased from 3.2 +/- 0.1 to 4.5 +/- 0.2 mEq/L. These results suggest that unlike hemodialysis, which is not associated with short-term changes in red-cell electrolytes, intermittent peritoneal dialysis results in a reversible increase in erythrocyte sodium. This change appears to be causally related to the decrease in extracellular potassium concentration.
对接受48小时间歇性腹膜透析的终末期肾病患者治疗前后获取的红细胞进行细胞内钠和钾浓度测定。红细胞钠浓度从7.5±0.3 mmol/L细胞增加至8.6±0.4 mmol/L细胞，平均增加1.1±0.1 mmol/L细胞（P<0.001），但红细胞钾浓度和细胞含水量基本未变。透析期间血浆钾浓度从4.2±0.2 mEq/L降至3.3±0.1 mEq/L（P<0.001）。红细胞钠浓度的增加与血浆钾浓度的降低相关（r = 0.51，P<0.01）。相比之下，未透析的慢性肾衰竭对照患者的红细胞钠和钾在相似时间段内未发生变化，血浆钾浓度也未改变（48小时前为4.3±0.1 mEq/L，48小时后为4.3±0.2 mEq/L）。将透析患者透析后的红细胞置于不同钾浓度的自身血浆中孵育，结果显示随着血浆钾浓度从3.2±0.1 mEq/L增加至4.5±0.2 mEq/L，细胞钠浓度的升高受到抑制。这些结果表明，与不会引起红细胞电解质短期变化的血液透析不同，间歇性腹膜透析会导致红细胞钠浓度可逆性升高。这种变化似乎与细胞外钾浓度降低存在因果关系。
