Korean Journal of Nephrology 1984;3(2):184-190.

혈액투석에 따르는 생체내 생화학적 변화

강성귀

Abstract

The present study is an investigation of the mechanism of changes in erythrocyte 2, 3-dipho- sphoglyceric acid(2,3-DPG) in patients with chro- nic renal failuze during hemod-ialysis. The study was conducted in 7 Korean and 6 American patie- nts on maintenance hemodialysis. Plasma and erythrocyte pH measured in Korean patients increase from 7. 31±0. 02 and 7. 13±0.02 before hemodialysis to 7.40±0.04 and 7.20±0.03 after hemodialysis(p<0. 001). Hemoglobin 2,3-DPG increased from 10. 862. 89 pmol/gm before hemodialysis to 19. 93±2. 89 pmol/ gm after hemodialysis(p<0. 001) in Korean patie- nts. Similary hemoglobin 2,3-DPG increased with nemodialysis from 12. 54±2. 53 pmol/gm to 18. 7E/ 6. 73 pmol/gm in 6 American patients. Blood glucose increased from 93. 3±8. 5 mg/dl before hemodialysis to 117. 1 ±6. 1 mg/dlafter hemodialysis in Korean patients. However, blood glucose concentration did not change signifieantly with hemodialysis in Ame- rican patients. Despite sulstantial anemia, l:emo- globin 2,3-DPG prior to hemodialysis was signifi- cantly lower than the values obtaiaed in the normal controls(17. 45±4. 28 mmol/gm). The incr- ease in blood glucose with hemodialy:is obaerved in Korean patients was probably attributable to the lower baseline glucose concentration and tle gain of glucese from dialysate, which had a glu- co e coneentration of 186.1±34.1 mg/dl. The results suggest that the ir.crease in 2,3-DFG with hemodialyeis is probably caused by inqrease in pH and inereased glueoee utilization.