[Abnormal erythrocyte sodium transport in patients with adult polycystic kidney and hypertension]

Abstract

The aim of this work was to evaluate the intracellular Na concentration, the passive Na permeability and the activity of Na, K pump, Na, K cotransport, Na, Li countertransport in the red cells of patients with autosomal dominant polycystic kidney disease (ADPKD) in relationship with their blood pressure status. Sixteen patients with ADPKD and normal renal function (6 males, 10 females, median age 31.5 years, range 20-42 years) and twenty healthy controls (10 males, 10 females, median age 30 years, range 23-47 years) were studied. Eight ADPKD were hypertensive. The rate constant of ouabain-sensitive Na efflux was lower in hypertensive than in normotensive ADPKD patients. The activity of Na,Li countertransport was significantly higher in hypertensive ADPKD patients than in both normotensive patients and control subjects. A significant inverse correlation was found between Na,Li countertransport activity and the rate constant of ouabain-sensitive Na efflux in fresh red cells (rho = 0.62; p = 0.016). Hypertension in patients with ADPKD and normal renal function is associated with abnormalities of red cell sodium transport: an increase of Na,Li countertransport, possibly primitive, and a reduction of Na,K pump in fresh cells, possibly secondary to a circulating inhibitor.