Abstract: SA-PO224
Hemodialysis Augments Red Blood Cell Death and Intracellular Hypoxia
Session Information
- Anemia and Iron Metabolism: Basic
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Anemia and Iron Metabolism
- 201 Anemia and Iron Metabolism: Basic
Authors
- Dias, Gabriela Ferreira, Pontifícia Universidade Católica do Paraná/PUCPR, Curitiba, PR, Brazil
- Andrade, Gabriela Bohnen, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
- Tozoni, Sara Soares, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil
- Grobe, Nadja, Renal Research Institute, New York, New York, United States
- Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
- Kotanko, Peter, Renal Research Institute, New York, New York, United States
- Moreno-Amaral, Andrea Novais, Pontifícia Universidade Católica do Paraná/PUCPR, Curitiba, PR, Brazil
Background
Previous studies have shown that uremia increases red blood cell (RBC) death (eryptosis) in hemodialysis (HD) patients, possibly aggravating their anemia. The present study tests the hypothesis that hemodialysis (HD) triggers eryptosis, as indicated by phosphatidylserine (PS) exposure, and calcium influx into RBC. In addition, we explored levels of RBC intracellular hypoxia.
Methods
RBC were obtained from healthy subjects (CON-RBC; n=8) and ESRD patients (HD-RBC; n=10) pre- and post-HD. Using flow cytometry, PS exposure (Annexin-V), calcium influx (Fluo 3-AM probe), and intracellular level of hypoxia (Hypoxia Green probe) were determined. Results are expressed in mean fluorescence units (MFI). We compared these parameters between healthy controls and pre- and post-HD, respectively.
Results
The age of the healthy subjects was 34.8±17.3 years, 20% were male. The patients were 73% males, the age was 58.1±18.1 years. Compared to CON-RBC, PS exposure, calcium influx, and levels of intracellular hypoxia were increased in HD-RBC pre- and post-HD, respectively. In addition, HD treatment was associated with significantly increased PS exposure and intracellular hypoxia (Table 1).
Conclusion
Taken together, our results suggest that HD increases RBC hypoxia, eryptosis, and RBC calcium influx. Lower oxygen levels in HD-RBC could be due to either an impaired uptake or enhanced release of oxygen. Oxygen-sensitive intracellular responses may regulate RBC lifespan.
Eryptosis and oxygen levels in RBC from healthy controls (CON-RBC) and hemodialysis patients (HD-RBC) pre- and post-HD.
| Parameters [in MFI units] | CON-RBC (n=8) | HD-RBC Pre-HD (n=10) | HD-RBC Post-HD(n=10) |
| Ca2+ influx | 31.9±14.6 | 60.9±17.4*** | 74±15.8*** |
| PS exposure | 2.6±1.6 | 12.5±6** | 27.2±7.2*** (#) |
| Hypoxia level | 9.7±2.3 | 14.63±3.3* | 22.15±4.9***(#) |
Data are shown as mean±SD of the Mean Fluorescence Intensity (MFI). *p<0.05, **p<0.01, ***p<0.001 correspond to the difference between HD-RBC and CON-RBC. (#) p<0.01 corresponds to the difference between pre-HD-RBC and post-HD-RBC.