High concentration of intraerythrocyte
ATP is a common phenomenon in patients with
chronic renal failure (CRF). It is likely that this is a result of increased plasma concentration of
adenine--one of
purine moiety donors which is necessary for
ATP synthesis. In the present study we monitored changes of both
adenine and intraerythrocyte
ATP concentration during
renal replacement therapy. We have also estimated the influence of
erythropoietin treatment. 4 groups of patients were included into the study: 22 patients with CRF, 22 patients on maintenance
hemodialysis treatment (11 patients with EPO
therapy), 19 patients after
kidney transplantation (7 patients with insufficiency of transplanted kidney) and 26 healthy volunteers served as a control group. The measurements were performed in plasma and erythrocyte extracts using HPLC. Significant decrease of high plasma
adenine concentration was observed after both HD session and successful
kidney transplantation, however the achieved values were still higher than in healthy volunteers.
Kidney transplantation resulted in a permanent decrease of plasma
adenine concentration, but along with the deterioration of transplanted kidney function, the plasma
adenine concentration reincreased. Also, it started to increase right after HD session had ended. On the other hand, the intraerythrocyte concentration of
adenine and
ATP after successful
kidney transplantation and single HD session came back to normal values. Also in this case, along with the deterioration of transplanted kidney function, both studied parameters reincreased. We have not observed any significant influence of
erythropoietin treatment on studied
adenine nucleotide concentration in
hemodialysis patients. The present study confirms the strong interrelationship between the
adenine nucleotide metabolism abnormalities and the advancement of
renal failure. The abnormalities intensify along with the
disease progression and the
renal replacement therapy results in partial their correction.