SICKLING PHENOMENON PRODUCED BY HYPERTONIC SOLUTIONS: A POSSIBLE EXPLANATION FOR THE HYPOSTHENURIA OF SICKLEMIA*

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Abstract
Erythrocytes containing S-hemoglobin become sickled when they are immersed in hyperosmotic solutions, even at the oxygen tension of room air and at normal body temperature and pH. The phenomenon is probably a result of cellular dehydration. It is suggested that when such cells enter the hypertonic and hypoxic milieu of the renal medulla, sickling is promoted, thereby increasing blood viscosity, selectively restricting blood flow to the medulla, limiting the production of a high concentration of sodium in the medullary interstitial fluid, and producing the hyposthenuria that characterizes patients with sickle-cell anemia.