Abstract

BackgroundImpaired T cell immune function exists in end-stage renal disease (ESRD) patients. Dialysis treatment may lead to changes in T cell subsets. In the present study, we aimed to identify alterations of T cell phenotypes in ESRD patients, especially in those receiving peritoneal dialysis (PD), and analyze the potential associated factors.MethodsIn the present study, 110 PD patients and 110 age/gender-matched hemodialysis (HD) patients who met the inclusion criteria were studied. Pre-dialysis blood samples were obtained and analyzed by flow cytometry to detect the expression of CD45RO and CCR7. Univariate and multivariate regression analyses were used to determine the factors associated with the alteration of T cell phenotypes.ResultsIn all dialysis patients, age was associated with the frequencies of both CD4+ and CD8+ naïve T cells, effector memory (EM) T cells and effector memory RA (EMRA) T cells but not central memory (CM) T cells. Dialysis modality was also associated with T cell subsets. Compared with HD patients, PD patients showed an increase in both CD4+ and CD8+ CM T cells and a reduction in both CD4+ and CD8+ EM and EMRA T cells. However, the number of CD4+ naïve T cells was lower and the number of CD8+ naïve T cells was higher in PD patients than those in HD patients. In PD patients, further multivariate analysis revealed that the frequency of CD4+ naïve T cells was positively associated with nPCR, while the frequency of CD8+ naïve T cells was negatively associated with age.ConclusionIn dialysis patients, the dialysis modality and age influence T cell subsets. There is a progression from naïve to effector T cells in HD patients compared with PD patients. In PD patients, different factors may influence the frequencies of CD4+ and CD8+ naïve T cells.

Highlights

  • Impaired T cell immune function exists in end-stage renal disease (ESRD) patients

  • The serum levels of hemoglobin, albumin, β2-MG, Aspartate aminotransferase (AST), as well as phosphorus, Parathyroid hormone (iPTH) and iron were significantly lower in peritoneal dialysis (PD) patients than those observed in HD patients

  • PD patients showed a marked reduction of IL-6 and TNF-α in comparison to HD patients. high-sensitive C-reactive protein (hsCRP), ferritin level and the prevalence of cytomegalovirus infection, did not differ significantly between PD and HD patients

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Summary

Introduction

Impaired T cell immune function exists in end-stage renal disease (ESRD) patients. Dialysis treatment may lead to changes in T cell subsets. We aimed to identify alterations of T cell phenotypes in ESRD patients, especially in those receiving peritoneal dialysis (PD), and analyze the potential associated factors. End-stage renal disease (ESRD) is associated with immune dysfunction, characterized as systemic inflammation and immune deficiency [1, 2]. In ESRD patients, T-cell mediated immune dysfunction results from an inverted CD4+/CD8+ ratio, marked loss of naïve T cells and accumulation of differentiated T cells [7,8,9]. With the loss of renal function, the abundance of naïve T cells decreases [8, 10]. The effect of dialysis modality, the effect of PD on T cell subsets, has not been fully discussed

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