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ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications.


ABSTRACT: Background:End-stage renal disease (ESRD) causes premature ageing of the immune system. However, it is not known whether hemodialysis (HD) and peritoneal dialysis (PD) similarly affect the T cell system. Methods:The aim of our study was to analyse whether dialysis modality may mitigate ESRD-induced immune senescence. We explored a large population of patients (675 ESRD patients) and both confirmed and refined the results in a second cohort (84 patients). Results:HD patients exhibited higher inflammatory monocytes counts (44/mm3 (1-520) vs 36/mm3 (1-161); p =?0.005). Patients on HD also had higher frequency of CD8 T cells (24% (7-61) vs 22% (8-42); p =?0.003) and reduced CD4/CD8 ratio. Such results were confirmed in the second cohort. Moreover, both CD4?+?CD57?+?CD28- (3.25% (0-38.2) vs 1.05% (0-28.5); p =?0.068) and CD8?+?CD57?+?CD28- (38.5% (3.6-76.8) vs 26.1 (2.1-46.9); p =?0.039) T cells frequencies were increased in HD patients. Telomere length did not differ according to dialysis modality, but was inversely related to ferritin levels (r =?-?0.33; p?=?0.003). There was a trend towards higher telomerase activity in PD patients (11?±?13 vs 6?±?11; p =?0.053). Thymic function was not different in PD and HD patients. Patients on PD before transplantation had a higher risk of acute rejection after kidney transplantation (HR, 1.61; 95%CI, 1.02 to 2.56; p =?0.041). Conclusions:More pronounced inflammation with hemodialysis may induce premature aging of the immune system. This observation correlates with a lower risk of acute kidney rejection in patients previously on HD. Clinical consequences in patients maintained on dialysis should be determined. Trial registration:Trial registration: NCT02843867, registered July 8, 2016.

SUBMITTER: Ducloux D 

PROVIDER: S-EPMC6050655 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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ESRD-associated immune phenotype depends on dialysis modality and iron status: clinical implications.

Ducloux Didier D   Legendre Mathieu M   Bamoulid Jamal J   Rebibou Jean-Michel JM   Saas Philippe P   Courivaud Cécile C   Crepin Thomas T  

Immunity & ageing : I & A 20180717


<h4>Background</h4>End-stage renal disease (ESRD) causes premature ageing of the immune system. However, it is not known whether hemodialysis (HD) and peritoneal dialysis (PD) similarly affect the T cell system.<h4>Methods</h4>The aim of our study was to analyse whether dialysis modality may mitigate ESRD-induced immune senescence. We explored a large population of patients (675 ESRD patients) and both confirmed and refined the results in a second cohort (84 patients).<h4>Results</h4>HD patients  ...[more]

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