Increased lymphocytic Na+/H+ exchange activity after hemodialysis: evidence for an endogenous inhibitor of Na+/H+ exchange in patients with end-stage renal failure.

The Na+/H+ exchange antiport activity was measured in lymphocytes from 16 patients with end-stage renal failure pre- and postdialysis. In addition the effect of the patients' plasma on lymphocytes from healthy subjects was tested. Resting pH (pHi) was not significantly different in lymphocytes pre- and postdialysis. On the other hand, the Na+/H+ exchange activity was significantly lower in lymphocytes before hemodialysis (6.22 +/- 0.73 x 10(-3) pHi/s) than after hemodialysis (9.32 +/- 1.58 x 10(-3) pHi/s; n = 16; p < 0.05). The buffer capacity was not significantly different before and after hemodialysis. The incubation of lymphocytes from healthy control subjects with plasma from patients with end-stage chronic renal failure significantly reduced the lymphocytic Na+/H+ exchange activity. The addition of ultrafiltrate also significantly reduced the Na+/H+ exchange activity in lymphocytes from healthy control subjects. The study indicates the existence of an endogenous inhibitor of the Na+/H+ exchange that is accumulated in plasma from patients with end-stage chronic renal failure.