The infusion of normal volunteers with 6 M urea in 10% invert sugar solution caused intravascular hemolysis similar to that reported in patients with sickle cell anemia. In vitro studies demonstrated that hypertonic solutions of urea and invert sugar caused little hemolysis, but these solutions preconditioned erythrocytes for lysis when the cells were resuspended in isotonic solutions. The primary mechanism for hemolysis appeared related to osomotic lysis of cells, but direct membrane injury could not be excluded as a contributing factor.

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