Virzì Grazia Maria, Clementi Anna, Ronco Claudio, Zanella Monica
Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, 36100 Vicenza, Italy.
IRRIV-International Renal Research Institute Vicenza, 36100 Vicenza, Italy.
Cells. 2025 Jun 24;14(13):967. doi: 10.3390/cells14130967.
Eryptosis is a programmed cellular death involving red blood cells (RBCs). It is a physiological mechanism that leads to the removal of defective erythrocytes, similarly to apoptosis. Its typical features are cell shrinkage, cell membrane blebbing, and membrane scrambling with the consequent exposure of the aminophospholipid phosphatidylserine on the outer surface of RBCs. Different mechanisms play a role in the pathogenesis of eryptosis, such as the increase in cytosolic calcium concentration, oxidative stress, inflammation, and uremic toxins. If erythrocyte synthesis does not compensate for the accelerated eryptosis, anemia may develop. Moreover, enhanced eryptosis contributes to the pathogenesis of different clinical diseases, such as diabetes, sepsis, metabolic syndrome, and uremia. In particular, in patients with chronic kidney disease (CKD), deficiencies of erythropoietin and iron may further reduce the lifespan of RBCs. In this review, we focused on eryptosis in CKD and end-stage renal disease on peritoneal dialysis (PD) and hemodialysis (HD).
红细胞凋亡是一种涉及红细胞（RBC）的程序性细胞死亡。它是一种生理机制，类似于凋亡，可导致有缺陷的红细胞被清除。其典型特征是细胞收缩、细胞膜起泡以及膜磷脂紊乱，从而使氨基磷脂磷脂酰丝氨酸暴露于红细胞外表面。不同机制在红细胞凋亡的发病机制中起作用，如胞质钙浓度增加、氧化应激、炎症和尿毒症毒素。如果红细胞生成不能补偿加速的红细胞凋亡，可能会发生贫血。此外，增强的红细胞凋亡有助于不同临床疾病的发病机制，如糖尿病、败血症、代谢综合征和尿毒症。特别是在慢性肾脏病（CKD）患者中，促红细胞生成素和铁的缺乏可能会进一步缩短红细胞的寿命。在本综述中，我们重点关注CKD以及腹膜透析（PD）和血液透析（HD）终末期肾病中的红细胞凋亡。
