MO438STUDY OF IMMUNOLOGICAL STATUS IN PATIENT OF CKD IN PREDIALYSIS STAGES

Abstract

Abstract Background and Aims It is known that inflammation is an important factor associated with the variability of the clinical picture in patients with chronic diseases. However, the question remains not completely clear: are immunological changes predictors of less stable control of the course of CKD. The aim of this study was a comprehensive assessment of the immunological status in patients with pre-dialysis stages of CKD. Method 80 patients (46 men and 36 women) with CKD in the outcome of nephropathies of diabetic and nondiabetic etiology, admitted to the Republican Medical Scientific and Practical Center for Therapy and Medical Rehabilitation, were examined. Chronic pyelonephritis without exacerbation was diagnosed in 31 patients, chronic glomerulonephritis - in 29, diabetic nephropathy - in 25 polycystic kidney disease - in 6 patients. Glomerular filtration was calculated based on serum creatinine concentration using the CKD-EPI formula (2011). A complex of immunological studies was performed. Immunotyping of lymphocytes was performed by flow cytofluorometry with the characterization of the main markers of immunocompetent cells. Results In patients with CKD, violations were observed in almost all links of immunological reactivity, first of all, a significant decrease in indicators of natural resistance (CD16 +, PS, PI) (p <0.05). The results of immunological monitoring showed a predominant violation of cellular defense mechanisms (CD3 +, CD4 +, CD8 +) (p <0.05), a multiple increase in inflammatory cytokines Il-4, TNF-α, IL-6 (p <0.05), in the absence of activation of humoral link and inadequacy of elimination mechanisms (CEC, p <0.05). Conclusion Our study showed that the immunological parameters were characterized by insufficient activation of the first line of defense of natural resistance, as well as specific mechanisms - an imbalance of the cellular and humoral links of immunity, hyperactivation of cytokine regulation in the absence of effector functions.