Vanadium, a trace element, as vanadate (VO43-) is known to interfere with a wide variety of enzymes including Ca2+ ATPase and Na+/K+ ATPase. VO43- is excreted mainly via the kidney. In renal insufficiency, the impaired VO43- excretion leads to VO43- accumulation in blood. The present study explored the effect of VO43- on eryptosis, the suicidal death of erythrocytes. Eryptosis is characterized by cell shrinkage and phosphatidylserine exposure at the erythrocyte surface. Eryptotic cells are phagocytosed and thus rapidly cleared from circulating blood. Stimulators of eryptosis include an increase of the cytosolic Ca2+ concentration. Erythrocyte Ca2+ activity was estimated from Fluo-3 fluorescence, phosphatidylserine exposure from annexin V-binding, and erythrocyte volume from forward scatter in FACS analysis. Exposure of erythrocytes to VO43- increased cytosolic Ca2+ concentration, enhanced the percentage of annexin V-binding erythrocytes, decreased erythrocyte forward scatter, and lowered the intracellular ATP concentration. In conclusion, VO43- induces eryptosis at least partially through increase of cytosolic Ca2+ concentration, an effect presumably contributing to the development of anemia in chronic renal failure. Copyright (C) 2008 S. Karger AG, Basel.