Biophysics of hemoglobin in chronic renal failure

The imbalance in acid-base buffer capacities of Hb prior to dialysis is due to the unfolding of Hb as a globular protein. The new groups which by unfolding become exposed to its surface could be responsible for H+ and OH+ receptors. The drop in heme-heme interaction b and indicated a low affinity of Hb to oxygen. This signify the adaptation of macromolecule to deliver oxygen to the tissue. This adaptation is lost post-dialysis due to the rapid shift from acidosis to alkalosis. Thus, Hb is folded after being unfolded pre-dialysis. However, a slight decrease in Met-Hb and sulf-hemoglobin content was detected with corresponding elevation of tetramer Hb