title: [End stage renal disease lymphopenia; characterization and clinical correlation].
abstract: BACKGROUND
  Patients with End Stage Renal Disease (ESRD), defined as those in Stage 5 of the Kidney Disease Outcome Quality Initiative (KDOQI) classification, have a number of acquired immune deficiencies secondary to the uremic stage, among them lymphopenia. In the present report, we retrospectively characterized the peripheral blood lymphocyte counts in a group of patients with ESRD and we related lymphopenia to their biochemical parameters and to the presence or absence of infections.
  
  
  METHODS
  Medical records from 190 patients in ESRD were selected from 282 medical records of patients being treated between February 2008 and November 2012 for kidney failure at different stages. A number of variables, including lymphocyte counts, biochemical parameters and infections, were analyzed at two different time points: Before and during dialysis.
  
  
  RESULTS
  ESRD patients analyzed had a well defined peripheral blood hematological pattern, characterized by severe chronic anemia, normal or elevated leukocyte count and normal or below normal lymphocyte count. The degree of hematological changes correlated with the depth of renal dysfunction and improved with dialysis along with the improvement of urea and creatinine values.
  
  
  CONCLUSIONS
  Lymphopenia was present in around half ESRD patients and was associated with increased infections, but they were of the same type as those present in ESRD patients without lymphopenia. Infections were different as those commonly associated with other immune deficiency lymphopenias. The implications of these findings are discussed.
authors.affiliation: Subdirección de Servicios Clínicos, Hospital de Especialidades Pediátricas, Tuxtla Gutiérrez, Chiapas, México. joselepe36@hotmail.com.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Lepe-Zúñiga
authors.forename: Pedro
authors.initials: P
authors.lastname: Morales-Molina
authors.forename: Gabriela Alejandra
authors.initials: GA
authors.lastname: García-Nandayapa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000276:immunology / Q000628:therapy; D018655:Lymphocyte Count; D008231:Lymphopenia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D055815:Young Adult
keywords: Chronic kidney failure; Chronic renal insufficiency; Lymphopenia; Uremia