Sodium transport in red cells of patients with acute viral hepatitis

The red blood cell composition was determined in 25 patients with acute viral hepatitis and in 26 normal subjects. The potassium concentration was 83.4 +/- 4.11 mmol/kg red cells (mean +/- SD) in hepatitis red blood cells and 79.7 +/- 4.74 mmol/kg red cells in the control samples (P < 0.005). There were no significant differences between the sodium content of normal and hepatitis red blood cells. 22Na-Efflux was determined in red blood cells of 17 patients with acute viral hepatitis and 18 normal subjects. The mean sodium efflux rate constant was 0.212 +/- 0.036 in red cells of patients with hepatitis and 0.295 +/- 0.046 in the control samples (P < 0.001). This difference resulted from a reduction in both the active and residual portions of the red blood cell sodium pump in the patients with viral hepatitis. Red blood cells of patients with acute viral hepatitis accumulated sodium at a significantly slower rate than normal red blood cells. The increase in osmotic fragility after 24 hr incubation at 37 degrees C in the absence of glucose was less prominent in hepatitis red blood cells than in normals. The findings of a reduced sodium efflux and slower accumulation of sodium during incubation, suggest that red blood cells from patients with viral hepatitis are less permeable to sodium, thereby leading to a new steady-state, characterized by a reduced sodium efflux.