Creatine, 2,3-Diphosphoglycerate and Anemia

Opaliński, Andrzej; Beutler, Ernest

doi:10.1056/nejm197108262850904

Cited by 38 publications

(12 citation statements)

References 15 publications

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“…This rise in P50std in late responders could be explained by the isolated increase in reticulocyte count. Young red cells contain more DPG [17], This is also confirmed by the negative correlation between ADPG and AHb. Along the T13-T25 period, anemia is corrected in all patients.…”

Section: Patient Data Before Treatment With Rhueposupporting

confidence: 59%

Effect of Recombinant Human Erythropoietin Treatment in Uremic Patients on Oxygen Affinity of Hemoglobin

Brunet

Berland²,

Merzouk³

et al. 1994

Nephron

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Anemia of chronic renal failure is associated with a reduced affinity of hemoglobin for oxygen (Hb-O₂ affinity). It has been reported that the correction of renal anemia by recombinant human erythropoietin (rhuEPO) treatment could be associated paradoxically with a further decrease in Hb-O₂ affinity. We investigated changes in the compensatory mechanisms of chronic renal anemia during 25 weeks of rhuEPO treatment, in 19 chronic hemodialyzed (HD) patients. There was no significant variation of mean standard P₅₀ (P₅₀std). Average 2,3-diphos-phoglycerate (DPG) increased after 13 weeks and remained stable. The large interindividual variations prompted us to study ΔP₅₀std and ΔHb. We demonstrated a negative correlation between ΔP₅₀std and ΔHb. Thus, P₅₀std increased in patients who did not immediately correct their anemia and decreased in patients whose Hb values rose. These data showed that the major factor influencing variations of Hb-O₂ affinity in chronic HD patients treated by rhuEPO is the variation of Hb concentrations. In our study, it was demonstrated that the most important rise in P₅₀std and 2,3-DPG occurred in patients who were late responders to rhuEPO.

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Section: Patient Data Before Treatment With Rhueposupporting

confidence: 59%

Effect of Recombinant Human Erythropoietin Treatment in Uremic Patients on Oxygen Affinity of Hemoglobin

Brunet

Berland²,

Merzouk³

et al. 1994

Nephron

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“…In renal failure the reticulocyte count is influenced by both the marrow transit time (Hillman & Finch, 1969) and maturation rate in the peripheral circulation (Baldini & Pannacciulli, 1960), but corrections for these factors are only valid in a steady state. Measurements were also made of red-cell creatine, which is high in young cells and falls gradually as the cell ages (Griffiths & Fitzpatrick, 1967) and correlates well with other markers of young cells (Opalinski & Beutler, 1971).…”

mentioning

confidence: 67%

“…Prior to transplant and despite anaemia reticulocyte counts were normal, confirming the depression of erythropoiesis. Similarly the estimates of red-cell creatine, although possibly biased by removal of some of the youngest red cells, were not increased prior to transplant; thus there was no evidence for a young cell population in the presence of an active marrow (Opalinski & Beutler, 1971).…”

Section: Discussionmentioning

confidence: 87%

Correction of anaemia following renal transplantation: serial changes in serum immunoreactive erythropoietin, absolute reticulocyte count and red‐cell creatine levels

Rejman

Grimes

Cotes³

et al. 1985

Br J Haematol

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Improvement of erythropoiesis following successful human renal transplantation in eight patients was monitored by sequential measurements of haemoglobin, red-cell creatine, absolute reticulocyte count and estimates of serum immunoreactive erythropoietin (siEp). SiEp increased in five patients after transplant, in three cases almost immediately after a return to normal of plasma creatinine. The increase in siEp was followed by a rise in the absolute reticulocyte count and red-cell creatine and finally by an increase in the haemoglobin level. As the haemoglobin approached normal levels a decline in the absolute reticulocyte count preceded a fall in siEp levels. Red-cell creatine also fell, though more gradually than the reticulocyte count. Acute graft rejection (in two patients) was associated with a fall in siEp. Chronic rejection (in one patient) was associated with persistent increases in siEp, reticulocyte count and red-cell creatine; this patient subsequently developed erythrocytosis.

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“…Furthermore, Opalinski and Beutler [27] have reported that the increase of 2,3-DPG synthesis in re sponse to anemia is much greater in patients with hemolytic anemia (including sickle cell anemia), with a young red cell population, than in patients with aplastic anemia, who have an older red cell popula tion. Thus young red cells appear to be more capable of responding to hypoxia than older red cells.…”

Section: Discussionmentioning

confidence: 99%

Glycosylated Hemoglobin Levels in a Benign Form of Sickle Cell Anemia in Saudi Arabia

et al. 1986

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Glycosylated hemoglobin was determined by the thiobarbituric acid method in sickle cell anemia patients from the Eastern Province of Saudi Arabia. The level of glycosylated hemoglobin in a Saudi SS sample (4.36%, SD 0.83) is 90% of that of the sample of normals (4.85%, SD 0.51). This is in contrast with the reported value of glycosylated hemoglobin in an American Black SS sample (3.9%, SD 0.6), which is only 60% of that of the sample of normals (6.6%, SD 0.7). The fetal hemoglobin level in Saudi sickle cell patients was 12.03% (SD 4.84), which is significantly different from that of Americans of African origin at p = 0.001. There was no significant correlation (r = 0.236) between the percentages of glycosylated Hb and Hb F at the 10% confidence level. The reported positive relationship between the percentages of glycosylated Hb and Hb F in American Blacks seems to be valid in the Saudi population only up to the level of 10–12% of fetal hemoglobin. Above this threshold of Hb F no further alleviating effect is seen. The 2,3-diphosphoglycerate value in Saudi Hb SS adults was 21.7 μmol/g (SD 7.4) and accordingly only twice as high as that of normal individuals. The benign clinical course exhibited by Saudi sickle cell patients is reflected by the survival of the RBC as indexed by its content of glycosylated Hb and 2,3-diphosphoglycerate. Moreover 10–12% of fetal hemoglobin in the RBC seems sufficient to ameliorate the severity of this disease in patients from the Eastern Province of Saudi Arabia.

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Creatine, 2,3-Diphosphoglycerate and Anemia

Cited by 38 publications

References 15 publications

Effect of Recombinant Human Erythropoietin Treatment in Uremic Patients on Oxygen Affinity of Hemoglobin

Effect of Recombinant Human Erythropoietin Treatment in Uremic Patients on Oxygen Affinity of Hemoglobin

Correction of anaemia following renal transplantation: serial changes in serum immunoreactive erythropoietin, absolute reticulocyte count and red‐cell creatine levels

Glycosylated Hemoglobin Levels in a Benign Form of Sickle Cell Anemia in Saudi Arabia

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