Erythrocyte Adenosine Triphosphate Depletion during Hypophosphatemia in a Uremic Subject

Abstract

In a patient with chronic renal disease and uremia who was under treatment with a low-protein diet, hemodialysis and aluminum hydroxide gel marked hypophosphatemia associated with anorexia, nausea, malaise, muscle weakness and mental depression developed. Erythrocyte ATP concentration was markedly reduced during the period of hypophosphatemia. Discontinuation of aluminum hydroxide gel completely reversed the biochemical abnormalities and the clinical symptoms. The restoration of erythrocyte ATP and the serum inorganic phosphorus were highly correlated. It is evident that under certain circumstances phosphate depletion in man may reach a severity that impairs erythrocyte energy metabolism. It is assumed that in the presence of marked hypophosphatemia, a similar reduction in ATP content may occur in somatic cells. Such an occurrence may have an important pathogenetic role in the symptoms observed.