title: Uremia causes premature ageing of the T cell compartment in end-stage renal disease patients.
abstract: BACKGROUND
  End-stage renal disease (ESRD) patients treated with renal replacement therapy (RRT) have premature immunologically aged T cells which may underlie uremia-associated immune dysfunction. The aim of this study was to investigate whether uremia was able to induce premature ageing of the T cell compartment. For this purpose, we examined the degree of premature immunological T cell ageing by examining the T cell differentiation status, thymic output via T cell receptor excision circle (TREC) content and proliferative history via relative telomere length in ESRD patients not on RRT.
  
  
  RESULTS
  Compared to healthy controls, these patients already had a lower TREC content and an increased T cell differentiation accompanied by shorter telomeres. RRT was able to enhance CD8+ T cell differentiation and to reduce CD8+ T cell telomere length in young dialysis patients. An increased differentiation status of memory CD4+ T cells was also noted in young dialysis patients.
  
  
  CONCLUSIONS
  Based on these results we can conclude that uremia already causes premature immunological ageing of the T cell system and RRT further increases immunological ageing of the CD8+ T cell compartment in particular in young ESRD patients.
authors.affiliation: Department of Internal Medicine, section Nephrology and Transplantation, Erasmus Medical Center, Rotterdam, the Netherlands. r.meijers@erasmusmc.nl.
authors.forename: Ruud Wj
authors.initials: RW
authors.lastname: Meijers
authors.forename: Nicolle Hr
authors.initials: NH
authors.lastname: Litjens
authors.forename: Elly A
authors.initials: EA
authors.lastname: de Wit
authors.forename: Anton W
authors.initials: AW
authors.lastname: Langerak
authors.forename: Ashley
authors.initials: A
authors.lastname: van der Spek
authors.forename: Carla C
authors.initials: CC
authors.lastname: Baan
authors.forename: Willem
authors.initials: W
authors.lastname: Weimar
authors.forename: Michiel Gh
authors.initials: MG
authors.lastname: Betjes