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Phagocytic polymorphonuclear function in patients with progressive uremia and the effect of acute hemodialysis

Sandeep Mahajan1, Om P Kalra, K Tripathi Asit

  • 1Department of Nephrology, All India Institute of Medical Sciences, New Delhi 110029, India. mahajansn@yahoo.com

Renal Failure
|August 3, 2005
PubMed
Abstract

Insights

In chronic kidney disease (CKD), polymorphonuclear leukocyte (PMN) function declines with uremia severity. Acute hemodialysis (HD) significantly improves PMN phagocytic index, suggesting uremic toxins impair immune defense.

Area of Science:

  • Nephrology
  • Immunology
  • Hematology

Background:

  • Infections are a major cause of mortality in chronic kidney disease (CKD) patients.
  • Polymorphonuclear leukocytes (PMNs) are crucial for host defense against infections.
  • PMN phagocytic function in uremia is inconsistently evaluated, with limited data on progressive uremia and hemodialysis effects.

Purpose of the Study:

  • To assess the phagocytic index (PI) of PMNs in patients with varying CKD severity.
  • To evaluate the impact of acute hemodialysis (HD) on PMN function in advanced renal failure.

Main Methods:

  • Assessed PI of PMNs using IgG-coated sheep erythrocytes.
  • Studied patients with mild-to-moderate and advanced renal failure, plus healthy controls.
  • Evaluated PI changes pre- and post-acute HD in advanced renal failure patients.

Main Results:

  • Significantly impaired PI in advanced renal failure (4.03 +/- 1.15) vs. mild-to-moderate (7.17 +/- 2.62) and controls (8.13 +/- 3.31).
  • No significant PI decline in mild-to-moderate CKD compared to controls.
  • Acute HD significantly improved PI in advanced renal failure patients (5.52 +/- 1.55 vs. 4.03 +/- 1.15).

Conclusions:

  • Phagocytic index of PMNs progressively declines with increasing uremia severity in CKD.
  • Improved PI post-hemodialysis suggests circulating uremic toxins impair PMN function.
  • This dysfunction contributes to increased infection susceptibility in CKD patients.

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