Studies on the biosynthesis of porphyrins in erythrocytes after incubation with delta-aminolevulinic acid: an attempt to investigate the pathogenesis of nephrogenic anemia.

The biosynthesis of porphyrins after incubation with 6.25 mmoles/l delta-aminolevulinic acid (ALA) for 4 h, the synthesis of porphobilinogen, the residual ALA, and the activity of the porphobilinogen synthase were determined in erythrocytes. Examined were 568 individuals: healthy males and female, normal pregnancy and nephropathy of pregnancy, newborn infants and various diseases of the kidney. The biosynthesis of porphyrin in erythrocytes after incubation with ALA and the activity of porphobilinogen synthase in erythrocytes in chronic renal disorders progressively decreased depending on the stages of the pathologic process and the development of chronic renal insufficiency. The high correlation between the level of synthesized porphyrins and hemoglobin led us to assume that disorders in porphyrin biosynthesis represent in fact one of the pathogenetic mechanisms of nephrogenic anemia.