title: Lymphocyte subset counts in continuous ambulatory peritoneal dialysis patients in relation to administration of recombinant human erythropoietin and angiotensin-converting enzyme inhibitors.
abstract: Estimation of lymphocyte subset counts (SLCs) is a useful tool in diagnosing nutrition and immune changes in continuous ambulatory peritoneal dialysis (CAPD) patients. Administration of recombinant human erythropoietin (rHuEPO) or angiotensin-converting enzyme inhibitors (ACEIs) can influence SLCs. Our aim was to evaluate the relationship between rHuEPO and ACEI doses and SLCs in the course of CAPD. In the group of studied patients (n = 55), 34 patients were taking rHuEPO and 38 patients were taking ACEIs. In 35 patients, enalapril was the ACEI used. Seven patients were taking rHuEPO, but not ACEIs; 11 patients were taking ACEIs, but not rHuEPO; 27 patients were taking rHuEPO and ACEIs both; and 10 patients were receiving neither rHuEPO nor ACEIs. Flow cytometry was used to estimate CD3, CD4, CD8, CD19, and CD16 + 56 antigens. In the study group, a correlation was seen between dialysis duration and rHuEPO dose (r = 0.395). No correlation was seen between CAPD duration and ACEI dose, but it was seen for total rHuEPO and ACEI doses (r = 0.327). A negative correlation was also seen between dialysis duration and CD19 cell count (r = -0.313). In patients taking only ACEIs (n = 11), a negative correlation was seen between total ACEI doses and CD16 + 56 cell count (r = -0.710). In patients who were not receiving rHuEPO or ACEIs, negative correlations were seen between dialysis duration and total lymphocyte count (r = -0.727), CD3 cell count (r = -0.706), CD4 cell count (r = -0.636), and CD8 cell count (r = -0.764). In conclusion, rHuEPO and ACEIs can influence the total lymphocyte count or lymphocyte subset counts--the natural changes being disturbed with prolongation of CAPD treatment. The possibility of this influence should be taken into account when evaluating lymphocyte counts as indices of nutrition and immune status.
authors.affiliation: Department of Nephrology, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
authors.forename: Alicja E
authors.initials: AE
authors.lastname: Grzegorzewska
authors.forename: Magdalena
authors.initials: M
authors.lastname: Leander
mesh_terms: D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D004656:Enalapril / Q000627:therapeutic use*; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011994:Recombinant Proteins
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D011994:Recombinant Proteins; D004921:Erythropoietin; D004656:Enalapril