Research Article| Volume 76, ISSUE 2, P267-279, August 1970

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Erythrocyte glycolysis, 2,3-diphosphoglycerate and adenosine triphosphate concentration in uremic subjects: Relationship to extracellular phosphate concentration

  • Marshall A. Lichtman
    Reprint requests: Marshall A. Lichtman, M.D., Dept. of Medicine, University of Rochester School of Medicine, Rochester, N. Y. 14620.
    From the Departments of Medicine, Radiation Biology and Biophysics, and Pediatrics, University of Rochester School of Medicine and Dentistry Rochester, N. Y., USA
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  • Denis R. Miller
    From the Departments of Medicine, Radiation Biology and Biophysics, and Pediatrics, University of Rochester School of Medicine and Dentistry Rochester, N. Y., USA
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  • Author Footnotes
    ∗ Dr. Lichtman is a Scholar of the Leukemia Society of America.
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      The red cell adenosine triphosphate (ATP) of uremic subjects was 70 per cent higher than that of healthy subjects. The elevated ATP in uremic red cells was not explained by the effect of anemia or increased reticulocytes on the concentration of red cell organic phosphate compounds; rather, red cell ATP concentration was highly correlated with serum phosphorus. The rate of red cell glucose utilization and lactate production was also greater in uremic hyperphosphatemic subjects than in healthy subjects. Plasma from uremic hyperphosphatemic subjects increased the ATP concentration, glucose utilization, and lactate production of normal red cells, whereas normophosphatemic normal plasma lowered the ATP concentration, glucose utilization, and lactate production of red cells from uremic subjects. Addition of phosphate to normal blood in concentrations similar to those seen in uremia increased the red cell ATP concentration, glucose utilization, and lactate production to rates seen in red cells of uremic subjects. Total red cell membrane adenosine triphosphatase (ATPase) was not significantly different in normal and uremic subjects. The rate of ATP hydrolysis in red cells suspended in autologous plasma containing 2.5 × 10−2M sodium fluoride was similar in uremic and healthy subjects. Red cell 2,3-diphosphoglycerate (2,3-DPG) was elevated in uremic subjects, was correlated with plasma phosphate, and could be increased to concentrations seen in uremic red cells by adding phosphate to normal blood or by placing normal red cells in uremic hyperphosphatemic plasma. Anemic subjects had higher red cell 2,3-DPG and lower ATP concentrations than anemic uremic subjects, although the total of these glycolytic intermediates was similar in amount in the two groups. Red cell 2,3-DPG in anemia due to decreased red cell production is associated with the severity of anemia in the absence of hyperphosphatemia (uremia). In uremic subjects, hyperphosphatemia is an additional determinant in the elevated glycolytic rate, ATP, and 2,3-DPG concentration. The additional contribution of hyperphosphatemia may explain in, part the preferential increase in ATP in uremic anemic as compared to nonuremic subjects with reticulopenic anemias.
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      2. Lichtman, M. A.: Divalent cation content of erythrocyte membranes. In preparation.

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