Peripheral Blood Lymphocyte Subsets Counts in Children on Regular Hemodialysis

Abstract

Background: Hemodialysis (HD) procedure per se as well as disturbances in both innate and adaptive immunity makes HD patients susceptible to infections. Infections are the major cause of morbidity and the second cause of death following cardiovascular events in HD patients. Aim: Was to study lymphocyte subset counts in children with chronic kidney disease on regular hemodialysis in comparison with normal subjects to clarify the abnormalities in cellular immune profile. Patients and methods: The study included 40children with chronic kidney disease on regular hemodialysis and 20 healthy control (HC) children age and sex matched as a control group, they were selected from the pediatric hemodialysis unit and out patients clinic of AL-zahraa hospital ,Al-Azher university during the period from September 2013to June 2014. We examined the number of the peripheral lymphocytes. Also quantification of (T CD3+ & B CD19+) lymphocytes and T cell subsets including T helper CD3+CD4+, T cytotoxic CD3+ CD8+, CD4/CD8 ratio, and NK cells CD3-CD56+ using flow cytometric analysis and correlates their number with clinical and laboratory characteristics. Results: The total peripheral blood lymphocyte count was lower in HD children (2.3 x10³/uL) than HC children (3 x10³/uL), also T lymphocytes CD3+ counts were reduced in HD children (1609.25 ±545.77 / uL) than HC (2114.20± 868.39 /uL), (p=0.008), numbers of CD4+ T cells were not different, but numbers of CD8+ T cells were lower in HD children (600.67±284.92) compared with HC (896.80±573.00) (p < 0.05). Decrease in NK cell counts CD3-CD56+ in HD children (175.35±107.44) in comparison to HC (271.30±169.94). The B lymphocyte count CD19+ was not different in HD children (260±201.6) compared with healthy controls (250.20±122.84). A positive correlation was found between B lymphocytes CD19+ with hemodialysis duration. A negative correlation between NK cell counts and BUN, age and also with patients weight and height were found. Conclusion: The reduced numbers of lymphocyte count, T lymphocytes CD3+counts, CD8+ T cells as well as NK cell in CKD children on regular hemodialysis may favor the frequent occurrence of infections in spit the normal number of the other studied t cell subsets.