Abstract

End-Stage Renal Disease (ESRD) is a chronic condition associated with systemic inflammation and uremic toxins, which can significantly compromise the integrity and function of circulating blood cells. This study investigates the specific alterations in erythrocyte (red blood cell) deformability and key cellular functions in patients diagnosed with ESRD. The primary objective was to quantify changes in the mechanical properties of the erythrocyte membrane, such as cellular elasticity and membrane fluidity, alongside functional parameters, including oxygen transport efficiency and susceptibility to oxidative damage. Erythrocytes were isolated from ESRD patients and healthy controls, and their biophysical characteristics were assessed using advanced techniques like ektacytometry and microfluidic analysis. Functional assays, including measurements of intracellular reactive oxygen species (ROS) levels and membrane-bound enzyme activity (e.g., Na+/K+-ATPase), were also performed. The results demonstrate a significant reduction in erythrocyte deformability and a corresponding increase in membrane rigidity in the ESRD cohort. Furthermore, these cells exhibited elevated ROS levels and diminished Na+/K+-ATPase activity, suggesting impaired ion homeostasis and increased oxidative stress. These findings highlight that the compromised mechanical and functional state of erythrocytes in ESRD contributes to microvascular complications and anemia, underscoring the need for therapeutic strategies targeting red blood cell health.