Hemodialysis influences the transport of water through the erythrocytic membrane, and induces morphologic and functional modifications. Recently water channels, called aquaporins (AQP), have been identified on the membrane of red blood cells. The aim of the present study was, therefore, to evaluate any relationships between volumetric changes in erythrocytes (MCV), plasma osmolarity and membrane expression of AQP1 in 22 uremic patients during a hemodialysis session, and compare value with those in a control group of 22 healthy volunteers. Membranal AQP1 expression was evaluated using three methods: indirect immunofluorescence under confocal microscopy, immunoenzymatic method after membrane extraction, and immunoblotting. In uremic subjects, at baseline membrane AQP1 expression was significantly lower, whereas plasma osmolality was higher than in controls. At 1 and 2 h of replacement therapy, a progressive increase was observed in erythrocytic AQP1, values similar to those in controls being attained after 3.5 h. During the session osmolality values reduced progressively, becoming significantly lower than basal values. The mean erythrocytic corpuscular volume in patients with ESRD was significantly lower than in cntrols at baseline. This value increased during hemodialysis, attaining statistical significance with respect to the basal value at 3.5 h of dialysis. Close correlations were found between plasma osmolality and AQP1 values (r = –0.930; p < 0.05), and also between MCV and plasma osmolality trend (r = –0.909; p < 0.05). There was a linear correlation (r = 0.63, p < 0.05) between plasma AVP concentrations and plasma osmolality. The variations found in plasma osmolarity during hemodialysis, may induce AQP1 expression on the membrane of intact red blood cells.

1.
Stabellini G, Bosi GP, Valeno V, Pellati A, Soffritti E, Masotti M, Fiocchi O, Calastrini C, Ricci G: Relation between the osmolality trend and ornithyne-decarboxylase activity in red blood cells of uremic patients during hemodialytic treatment. Biomed Pharmacother 1998;52:166–168.
2.
Brugnara C, Kruskall MS, Johnstone MR: Membrane properties of erythrocytes in subjects undergoing multiple blood donations with or without recombinant erythropoietin. Br J Haematol 1993;84:118–130.
3.
Oh MS, Levison SP, Carrol HJ: Content and distribution of water and electrolytes in maintenance hemodialysis. Nephron 1975;14:421–432.
4.
Gellert R, Billip-Tomecka Z, Bogdanska-Straszynska B, Malecka B, Sicinski A: Intradialytic erythrocyte volume changes. Nephrol Dial Transplant 1991;6(suppl 3):10–13.
5.
Agre P, Bonhivers M, Borgnia MJ: The aquaporins blueprints for cellular plumbing systems. J Biol Chem 1998;273.
6.
Smith BL, Agre P: Erythrocyte Mr28.000 transmembrane protein exists as a multisubunit oligomer similar to channel proteins. J Biol Chem 1991;266:6407–6415.
7.
Yang B, Ma T, Verkman AS: Erythrocyte water permeability and renal function in double knockout mice lacking aquaporin-1 and aquaporin-3. J Biol Chem 2001:276:624–628.
8.
Corica F, Ientile R, Allegra A, Romano G, Cangemi F, Di Benedetto A, Buemi M, Cucinotta D, Ceruso D: Magnesium levels in plasma, erythrocyte and normotensive patients with type II diabetes mellitus. Biol Trace Element Res 1996;51:13–21.
9.
Sargent JA, Gotch FA: Principles and biophysics of dialysis; in Drukker W, Parson FM, Maher JF (eds): Replacement of Renal Function by Dialysis. Boston, 1978 vol 3, pp 38–68.
10.
Quarello F, Boero R, Guarena C, Rosati C, Girando G, Giacchino F, Piccoli G: Acute effects of hemodialysis on erythrocyte sodium fluxes in uremic patients. Nephron 1985;41:22.
11.
Flemming SJ, Cattel WR: Red cell volume and plasma sodium. Nephron 1985;41:126.
12.
Calzavara P, De Angeli S, Nieri A, Furlan C, Bolzonella R, Da Porto A: Alterations in erythrocyte morphology induced by blood pumps. J Artif Organs 1993;16:653–658.
13.
Fasanella D’Amore T, Wauters JP, Waeber B, Nussberger J, Brunner HR: Response of plasma vasopressin to changes in extracellular volume and/or plasma osmolality in patients on maintenance hemodialysis. Clin Nephrol 1985;23:299–302.
14.
Buemi M, Corica F, Di Pasquale G, Aloisi C, Sofi M, Casuscelli T, Floccari F, Senatore M, Corsonello A, Frisina N: Water immersion increases urine excretion of aquaporin-2 in healthy humans. Nephron 2000;85:20–26.
15.
Buemi M, D’Anna R, Di Pasquale G, Floccari F, Ruello A, Aloisi C, Leonardi I, Frisina N, Corica F: Urinary excretion of aquaporin-2 water channel during pregnancy. Cell Physiol Biochem 2001;11:203–208.
16.
Nielsen S, Kwon T, Christensen BM, Promeneur D, Frokiaer J, Marples D: Physiology and pathophysiology of renal aquaporins. J Am Soc Nephrol 1999;10:647–663.
17.
Jenq W, Mathieson IM, Ihara W, Ramirez G: Aquaporin-1: An osmo-inducible water channel in cultured mIMCD-3 cells. Biochem Biophys Res Commun 1998;245:804–809.
18.
Carlsson O, Nielsen S, Zakaria el-R, Rippe B: In vivo inhibition of transcellular water channels (aquaporin-1) during acute peritoneal dialysis in rats. Am J Physiol 1996;271:H2254–H2262.
19.
Ma T, Song Y, Yang B, Gillespie A, Carlson EJ, Epstein CJ, Verkman AS: Nephrogenic diabetes insipidus in mice lacking aquaporin-3 water channels. Proc Natl Acad Sci USA 2000;97:5434–5439.
20.
Cheng W, Wang CX, Chen WZ, Xu, YW, Shi YY: Investigating the dielectric effects of channel pore water on the electrostatic barriers of the permeation ion by the finite difference Poison-Boltzamann method. Eur Biophys J 1998;27:105–112.
21.
Murata K, Mutsuoka K, Hirai T, Walz T, Agre P, Heymann JB, Engel A, Fujiyoshi Y: Structural determinants of water permeation through aquaporin-1. Nature 2000;407:599–605.
22.
Cho MR, Knowles DW, Smith BL, Moulds JJ, Agre P, Mohandas N, Golan DE: Membrane dynamics of the water transport protein aquaporin-1 in intact human red cells. Biophys J 1999;76:1136–1144.
23.
Krzezinski JM, Godon JP, Rorive GL: Erythrocyte sodium-potassium activities, plasma natriuretic activity, and peripheral vascular resistances during hemodialysis or hemofiltration. J Clin Hypertens 1985;1:245–256.
24.
Prasad R, Mond R, Jain S, Kaur G, Chugh KS: Modulation of ouabain sensitive sodium potassium pump of erythrocytes from patients with chronic renal failure: role of acute hemodialysis. Biochem Mol Biol Int 1996;40:1087–1094.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.