Erythrocyte osmotic fragility is a laboratory test which evaluates the stability of the erythrocyte membrane to osmotic stress. The aim of this review is to highlight research findings on the intrinsic and extrinsic factors that influence erythrocyte osmotic fragility. The extrinsic factors include the type, ionic strength and pH of incubation media, type of anticoagulant and storage time of the blood, ambient temperature, drugs, medicinal plant extracts, xenobiotics, chemical agents; whereas intrinsic factors are age, sex, breed, species, pregnancy, lactation and genetic factors. Membrane composition, ion transports, aquaporin action, lipid peroxidation, and eryptosis of erythrocytes are involved in the variability of osmotic fragility. Increased osmotic fragility and improved osmotic stability of erythrocytes are pathophysiological phenomena that require appropriate interpretation in research or clinical investigation and the understanding of the factors affecting osmotic fragility will aid in the laboratory assessment of conditions related to erythrocytes where erythrocyte osmotic fragility test is used.
Key words: Erythrocyte, Extrinsic factors, Intrinsic factors, Osmotic fragility, Osmotic stability
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