The changes of plasma soluble CD40 and soluble CD40L in patients with chronic renal failure and their clinical significance / 中华急诊医学杂志

ABSTRACT

Objective To investigate the changes of plasma soluble CD40 (sCD40) and soluble CD40L (sCD40L) in patients with chronic renal failure( CRF) and their potiential mechanisms in renal injury and immunodeficiency. Method From September to December 2006, 30 CRF patients without hemodialysis (CRF group) in department of Nephrology and 30 uremic patients receiving maintenance hemodialysis for more than 3 months ( HD group) in dialysis center in Beijing TongRen Hospital of Capital Medical University, were enrolled in this study. The normal control group consisted of 20 healthy volunteers who matched with study subjects for age and gender. The levels of plasma sCD40 and sCD40L were measured by the method of enzyme linked immunosorbent assay (ELISA). The relationship between sCD40, sCD40L and related factors were analyzed, and the influence of hemodialysis on sCD40 and sCD40L were observed. ANOVA and Pearson correlation analysis were used in statistical analysis. Results (1) The sCD40 levels in CRF group and HD group were significantly higher than those in control group(P ＜ 0.01). The sCD40 levels in HD group were also higher than those in CRF group(P ＜ 0.01). (2) The sCD40L levels in CRF group and HD group were significantly higher than those in control group (P ＜ 0.01). The sCD40L levels in HD group were slightly higher than those in CRF group, but without significant difference (P ＞ 0.05). (3) In CRF group, the sCD40 levels correlated positively with serum creatinine (Scr) and C-reactive protein(CRP) (r = 0.637,P ＜ 0.01,r = 0.551,P ＜ 0.05). The correlations between sCD40L and Scr and CRT were also seen (r = 0.553, P ＜ 0.05, r = 0.686,P ＜ 0.01), whereas the correlation with blood pressure,hemoglobin (Hb), platelet(PLT), white blood cell(WBC), serum albumin(Alb), glucose (Glu),blood urea nitrogen(Bun)and serum lipid was no seen (P ＞ 0.05). In HI) group, there were no correlations between sCD40,sCD40L and above parameters (P ＞ 0.05), there were also no correlations between sCD40, sCD40L and duration of the treatment by dialysis and dialysis adequacy(Kt/V) (P ＞ 0.05). (4)After one HD session, the post-HD levels of sCD40 were slightly higher than pre-HD levels, but without statistical difference ( P ＞ 0.05). The post-HD levels of sCD40L were obviously lower than pre-HD levels, with significant difference (P ＜ 0.01). Conclusions The levels of sCD40 and sCLMOL in CRF patients,particularly in HD patients, were significantly higher than those of controls, which may participate in pathogenesis of renal injury and immunodeficiency.