Abstract
Anemia can be compensated by a decreased Hb-O2 affinity shifting the Hb-O2 dissociation curve to the right. We studied this mechanism in 3 groups of CRF children of similar age and serum phosphate levels: On conservative treatment(CT:n=21, SCR 4,7 mg/dl,Hb 10.2 g/dl,pH 7.35) on regular haemodialysis (HD:n=10, Hb 7.6 g/dl, pH 7.38) and with a functioning transplant (TP:n=7, SCR 1.0 mg/dl,Hb 14 g/dl, pH 7.40). Hb-O2 dissociation curves were measured directly (Hem-O-Scan) in capillary blood and the O2 pressure leading to half-saturation of Hb at pH 7.40 (p50c) was calculated. In spite of different Hb levels p50c was similar in CT(25.1 mmHg), HD(25.9) and TP(26.6). p50c correlated inversely with BUN(r=0.54) but less with SCR. The inverse correlation between p50c and Hb was dependent on BUN levels. At a given Hb the p50c was highest in TP(30.8 mmHg) and lowest in CT with BUN levels > 70 mg/dl(21.3 mmHg). The influence of BUN on the correlation between Hb and p50c indicates a negative effect of uremia on O2 release. The uremia-induced shift of the Hb-O2 dissociation curve to the left might be explained by an inhibition of the erythrocyte 2,3-diphosphoglycerate synthesis.
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Müller-wiefel, D., Schärer, K. HAEMOGLOBIN-OXYGEN(Hb-O2) DISSOCIATION IN CHILDREN WITH CHRONIC RENAL FAILURE (CRF). Pediatr Res 14, 1017 (1980). https://doi.org/10.1203/00006450-198008000-00264
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DOI: https://doi.org/10.1203/00006450-198008000-00264
