Urea movement across erythrocyte membrane during artificial kidney treatment

Previous work by other investigators indicates that erythrocyte urea and creatinine in uremic whole blood leaving the hemodialyzer do not move down the concentration gradients established by loss of these solutes across the dialyzer membrane. This puzzling disequilibrium is at odds with work indicating ready movement of both solutes across the erythrocyte membrane of nonuremic erythrocytes studied in vitro. The present study shows that contact with the dialyzer does not noticeably alter the erythrocyte membrane of the uremic patient, so that urea distribution between plasma and erythrocyte water is the same as that in the blood of normal control subjects. Furthermore, urea does not show a disequilibrium in concentration across the erythrocyte membrane in response to 50% dilution with a modified Ringer's solution but rather equilibrates swiftly and completely.