[Adenine nucleotide- and 2,3-diphosphoglycerate metabolism in human erythrocytes in chronic kidney insufficiency].

In 38 patients with chronic renal insufficiency of different degree of severity examinations of the stationary concentration of the adenine nucleotides in the erythrocytes were carried out. It was shown that in the red blood cells of uraemics a genuine increase of the concentration of these compounds occurs, in which case the adenosine triphosphate dominates absolutely as well as relatively. In individual cases erytho-cyctic ATP-values of more than 3 micron mol pro ml cells may be achieved. The increase of the ATP-concentration in the red blood cells correlates with the degree of severity of the renal insufficiency and the renal anaemia. The hyperphosphataemia occurring as a rule in renal insuficiency is of causal importance for the increase of ATP. By a consecutive increase of the intracellular phosphate level and by influence on different steps of enzymes (phosphofructokinase, aldolase, glycerin aldehyde phosphate dehydrogenase) and changed regulations it effected an activation of the glycolysis. The increase of the plasma adenine and plasma adenosine concentration plays apparantly an accessory role for the increase of the concentration of the adenine nucleotides existing in the erythrocytes. Together with an increased concentration of 2,3-diphosphogycerate (2,3-DPG) the increase of the ATP-level has an effect on the oxygen transport function function of haemoglobin in the sense of a facilitation of the O2-output. These processes explain the relative adaption of patients with chronic renal insufficiency to renal anaemias of partly high degree.