Study of the Cellular Immune Response according to Hemodialysis Duration in Chronic Renal Failure Patients

ABSTRACT

BACKGROUND: In order to evaluate the effects of the duration of hemodialysis on cell mediated immunity, we studied cellular immune responses in vitro in 12 patients on chronic hemodialysis and in 6 healthy volunteers with normal kidney function. METHODS: The patients on maintenance hemodialysis were divided into two subgroups according to the duration of the hemodialysis Group 1 (within 5 years, n=6) and Group 2 (>5 yr and < or =10 yr, n=6). Group 3 include the normal control (n=6). The peripheral blood lymphocytes of each group were cultured in RPMI medium 1640 without/or with 3 microgram of phytohemagglutinin (=PHA) for 7 days. RESULTS: CD4 /CD8 ratio at 48hours was totally comparable between the uremic patients (Group 1 and Group 2) and the controls (Group 3). The proportions of CD25 T lymphocytes after 48 hours culture were abnormally high 7.1+/-0.5% and 7.0+/-1.3% in the uremic patients as compared to 2.5+/-0.6 in the normal controls at the basal state and 66.7+/-2.6% and 68.8+/-1.9% in the uremic patients as compared to 78.3+/-4.6% in the normal controls at the PHA-stimulated condition. The spontaneous production of IL-2 (mean pg SEM) was significantly lower in hemodialized patients (Group 1 34.5+/-6.0 pg/ml, Group 2 33.8+/-6.2 pg/ml) as compared to the normal patients (Group 3 58.8+/-10.4 pg/ml). The PHA stimulated IL-2 production was also significantly reduced in the hemodialized patients (Group 1 53.2+/- 13.3 pg/ml, Group 53.0+/-10.3 pg/ml) as compared to the normal patients (Group 3 150.0+/-24.5 pg/ml). The mean proliferative response to PHA at each point in the hemodialized patients were significantly lower than those of the controls. CONCLUSIONS: These data show that there is no significant correlation between the level of the cell mediated immune response and the duration of hemodialysis. Several defects in the cell mediated immune response associated with uremia might start at an early phase of the hemodialysis.