title: Total and subset lymphocyte counts, angiotensin converting enzyme inhibitors, and dialysis duration in younger and older peritoneal dialysis patients.
abstract: Disturbances in immunity and nutrition status worsen in peritoneal dialysis (PD) patients with advancing age. In the present study, we evaluated variations in total lymphocyte count (TLC) and subset lymphocyte counts (SLCs) with respect to the age of PD patients. We carried out the study in two groups of PD patients. Group I patients (n = 12) were less than 40 years of age (35.5 +/- 5.4 years), and their PD duration was 18.2 +/- 9.4 months. Group II patients (n = 14) were more than 60 years of age (67.2 +/- 5.1 years), and their PD duration was 20.6 +/- 11.0 months. In group I, 9 patients were taking angiotensin converting enzyme inhibitors (ACEIs); in group II, 10 patients were taking ACEIs. We used flow cytometry to estimate SLCs (determining CD3, CD4, CD8, CD19, and CD16+56 antigens). In both groups, the mean CD19, CD4, and CD8 counts were lower than the normal ranges. In group II, TLC and CD3 count were also lower than normal. In group I, correlations were seen between age and TLC, CD3, CD19, CD4, and CD8. Correlations were also seen between dialysis duration and TLC, CD3, CD19, and CD4, and between total ACEI dose and CD19 count. In group II, correlations were seen between age and TLC, CD3, and CD8. No correlation was observed between PD duration and TLC or SLCs, but a correlation between total ACEI dose and CD8 count was seen. In patients who were taking enalapril as their only ACEI, a correlation was observed between total enalapril dose and TLC, CD3, and CD8. Our results confirm data that indicate worse immunity and nutrition status in older PD patients and demonstrate decreasing values of TLC and SLCs with aging in younger and older PD patients alike. Administration of ACEIs negatively influences SLCs independently of age, but decreases in TLC and SLCs are significantly related to PD duration only in younger patients.
authors.affiliation: Chair and Department of Nephrology, Transplantology and Internal Diseases, Karol Marcinkowski University of Medical Sciences, Poznań, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Leander
authors.forename: Alicja E
authors.initials: AE
authors.lastname: Grzegorzewska
authors.forename: Marcin
authors.initials: M
authors.lastname: Karolewski
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000276:immunology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D015703:Antigens, CD / Q000032:analysis; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010530:Peritoneal Dialysis; D013997:Time Factors
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D015703:Antigens, CD