Abstract
At the moment it is unknown to what extent the impaired function of T lymphocytes in ESRD patients depends on uremia, and to what extent on hemodialysis (HD) procedure. Therefore, the purpose of the study was to evaluate percentages of T lymphocyte subpopulations ex vivo, plasma concentrations of IL12p70, TNF, IL-10, IL-6, IL-1β, IL-8 cytokines and selected proliferation parameters of in vitro activated T lymphocytes in HD patients before and after single HD procedure using flow cytometry. We demonstrated that the percentage of CD8+ cells ex vivo was decreased while the CD4+/CD8+ ratio was increased after HD procedure. Also, there was significant decrease in the percentage of CD8+HLA-DR+, CD8+CD69+ and CD8+CD95+ cells after HD. At the same time, an increase in the percentage of CD4+CD95+ cells was observed after HD. From all analyzed cytokines, only the concentration of IL-8 was significantly decreased after HD procedure. A single HD session enhanced proliferation capacity of CD4+ cells but not CD8+ cells in vitro by increasing number of cell divisions and percentage of dividing cells. Our results show that a single hemodialysis can have immunomodulatory effect on HD patients and may contribute to the state of immune deficiency observed in patients with ESRD.
Highlights
Chronic kidney disease (CKD) is characterized by the slow loss of kidney function over a period of years that leads to its fifth stage – end-stage renal disease (ESRD)
Majority of scientific articles describing the abnormal function of the immune cells, especially T lymphocytes, in ESRD is based on the results obtained predominately in HD patients
Our previous study demonstrated that CD4+ T lymphocytes of ESRD patients treated with continues hemodialysis have significant disturbances in surface phenotype and reduced proliferation capacity compared with predialysis patients even though synthetic membranes are used[11]
Summary
Chronic kidney disease (CKD) is characterized by the slow loss of kidney function over a period of years that leads to its fifth stage – end-stage renal disease (ESRD) Patients at this stage require renal replacement therapy, which is usually hemodialysis, to reduce the side effects of kidney disease, especially uremia, fluid volume overload and metabolic acidosis. It is believed that the main cause of immune deficiency is the accumulation of uremic toxins, a process which is associated with the progression of renal disease[3] Though, it seems that it may be a result of repeated hemodialysis treatments. Recent studies have shown that after HD session the percentage of CD25+ cells along with plasma level of IL-6 increases in diabetic patients[15], which suggest that even a single hemodialysis procedure can prime an activation of peripheral blood lymphocytes. We analyzed proliferation capacity of in vitro stimulated T lymphocytes obtained before and after a single HD in order to establish whether single procedure could influence their activity
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