Abstract
Problem statement: The incidence of infectious diseases is increased in patients with chronic renal failure. Chronic renal failure severely influences the immune functions of the host. Approach: To evaluate the antitetanus immunity level in southern Iranian patients with end stage renal disease undergoing hemodialysis and to find its association with sex, age, blood hemoglobin and serum albumin, duration of dialysis. This cross sectional study was carried out on a total of 52 patients, who were on hemodialysis and 52 age and sex matched healthy individuals with without any underlying renal disease as a control group. Individuals in the both groups receiving antitetanus toxoid vaccine or immunoglubins a year prior to the study were excluded. The serum antitetanus IgG antibody levels were measured by an ELISA method. Results: Tetanus protected individuals in the patients and the control groups were 34.6 and 63.30% respectively. Of the evaluating factors just hemodialysis duration found to affect on tetanus immunity. Conclusion: Tetanus protected individuals in the patients group were significantly less than tetanus protected individuals in the control group (p = 0.011). Hemodialysis duration has significant effect on antitetanus immunity level.
Highlights
Infectious diseases are the leading cause of death in End-Stage Renal Disease (ESRD) patients, second only to cardiovascular disease
This is thought to be due to an immunosupressed status in this population[3,4,5,6,7]. This is thought to be related to an impaired T cell activation by antigen presenting cells[8], impaired immune Responses and Antigen-Specific Memory CD4+ T Cells[5], impaired monocyte and monocyte-derived dendritic cell function[4], defects in NK cell function[6], immunodeficiency status manifested decrease in the number of CD3+, CD4+ and CD72+ cells and phagocytosis intensification[7], T and B-lymphocyte abnormalities and impaired responses to T cell dependent pathogens such as hepatitis B virus[9,10,11,12,13]
Subjects: This cross sectional study was carried out on a total of 52 patients (36 men and 16 women), with a mean age of 57.75±14.26 years, who were on hemodialysis due to end-stage renal disease in the Hemodialysis Center of Jahrom University of Medical Sciences in 2009
Summary
Infectious diseases are the leading cause of death in End-Stage Renal Disease (ESRD) patients, second only to cardiovascular disease. The immune response to various vaccinations is impaired in patients with chronic renal failure[16], requiring multiple boosts to generate a robust protective response (e.g., hepatitis B, diphtheria, pertussis and tetanus)[22,23,24]. Subjects: This cross sectional study was carried out on a total of 52 patients (36 men and 16 women), with a mean age of 57.75±14.26 years, who were on hemodialysis due to end-stage renal disease in the Hemodialysis Center of Jahrom University of Medical Sciences in 2009.
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