Efficiency of red cells hexose monophosphate shunt in uraemic patients: its role in shortening red cell survival

ABSTRACT

This work was performed to study the hexose monophosphate [HMP] shunt especially G6PD level in uraemic patients' red cells and its role in haemolysis. Besides 10 healthy controls, this study was conducted on 30 chronic renal failure [CRF] cases divided into 3 groups. In group I, patients' serum creatinine was below 5 mg/dl, in group II it was 5-10 mg/dl and in group III, it was above 10 mg/dl. Following proper history taking and thorough clinical examination, all patients and controls were subjected to urine analysis, complete blood count as well as determination of their serum iron, total iron binding capacity, transferring saturation, bone marrow examination, iron stores in addition to blood urea, serum creatinine, sodium, potassium total calcium and inorganic phosphorus. Thereafter, G6PD activity was estimated. Our results confirmed occurrence of anaemia and haemolysis in CRF patients. G6PD levels were significantly reduced in 20, 40 and 60% of group I, II and III cases respectively. Therefore, HMP shunt activity was reduced in CRF due to decreased G6PD enzyme activity. This diminution became more prominent with rise of serum creatinine. Thus, decreased G6PD activity could be considered as a cause of haemolysis in CRE