One-year immunological evaluation of chronic hemodialysis in end-stage renal disease patients.
BACKGROUND
Much research has been devoted to the determination of acute leukocyte activation as well as acute cytokines production during and after blood hemodialysis membrane interaction. In contrast, few studies deal with chronic immunological evaluation of T-cell activation markers in hemodialysis.


METHODS
We evaluated different immune parameters using a modified cellulose low-flux hemophan vs. synthetic high-flux polyamide membrane during 1 year in 35 stable chronic hemodialysis patients. Leukocyte counts, lymphocyte subpopulations, T-cell activation markers (CD69, CD25, HLA-DR, CD54, CD62L, CD45RO, CD11a, CD28), complement-activation products (C3a) and serum elastase were measured at 0, 3, 6 and 12 months in the two patient groups and compared to 13 healthy control subjects.


RESULTS
Over dialysis time, all patients showed a significant level elevation of CD69/CD3 (p < 0.005) and CD25/ CD3 (p < 0.005) phenotypes. In contrast, HLA-DR and CD45RO remained unchanged suggesting a truncated pattern of activation. T lymphocyte subset analysis showed in both hemodialyzed groups a significant decrease in the expression of CD54 (ICAM-1) when compared to controls (p < 0.005). C3a and elastase measurements showed a significant upward trend with dialysis time in both hemodialyzed groups.


CONCLUSIONS
Although the immunological changes seen in chronic hemodialyzed patients must be interpreted in conjunction with their basal uremic states and the membrane permeability properties, our study suggests that 1-year immunological evaluation of hemodialysis membranes biocompatibility is associated with changes in the pattern of chronic T-cell activation, which is in part related to the use of a particular membrane type. Moreover, some key molecules (CD54) are affected in patients with end-stage renal disease undergoing hemodialysis.
Meier
P
P
Division of Nephrology, University Hospital, University of Lausanne, Switzerland.
von Fliedner
V
V
Markert
M
M
van Melle
G
G
Deppisch
R
R
Wauters
J P
JP
D000368:Aged; D015703:Antigens, CD / Q000097:blood; D001672:Biocompatible Materials / Q000592:standards; D015415:Biomarkers / Q000097:blood; D003167:Complement Activation / Q000502:physiology; D004797:Enzyme-Linked Immunosorbent Assay; D005069:Evaluation Studies as Topic; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D016130:Immunophenotyping; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000628:therapy*; D007958:Leukocyte Count; D008213:Lymphocyte Activation / Q000502:physiology; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D016176:T-Lymphocyte Subsets / Q000145:classification / Q000276:immunology
D015703:Antigens, CD; D001672:Biocompatible Materials; D015415:Biomarkers; D008567:Membranes, Artificial; D018799:Intercellular Adhesion Molecule-1; D010196:Pancreatic Elastase