Anemia and red blood cell deformability in proteinuric chronic kidney disease

Bissinger et al. recently reported that proteinuric chronic kidney disease, in both mice and humans, is associated with reduced red blood cell (RBC) deformability and increased RBC lysophospholipid content.1 Blood albumin levels were not reported but presumably were low in mice with doxorubicin-induced nephrotic syndrome or deletion of podocin-induced nephrotic syndrome as both models showed massive and progressive proteinuria. Lysophosolipid in the circulation is normally bound to albumin, and hypoalbuminemia leads to increased lysopholipid in low-density lipoprotein2 and in RBCs.