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In vitro evidence for impaired cellular immune responsiveness in children with chronic renal failure
Insights
Children with chronic kidney disease show reduced immune cell function. Hemodialysis patients had a weaker response than those on peritoneal dialysis, indicating impaired cellular immunity in pediatric renal failure.
Area of Science:
- Immunology
- Nephrology
- Pediatrics
Background:
- Chronic renal insufficiency (CRI) and chronic renal failure (CRF) can impact immune system function.
- Previous studies suggest immune dysfunction in adult populations with renal failure.
Purpose of the Study:
- To evaluate the in vitro cellular immune functions in children with CRI or CRF.
- To compare immune responses between different treatment modalities in pediatric CRF patients.
Main Methods:
- Mixed lymphocyte culture (MLC) assay was used to assess lymphocyte proliferative response.
- Patients with CRI/CRF were compared to healthy control individuals.
- CRF patients undergoing hemodialysis were compared to those on continuous ambulatory peritoneal dialysis (CAPD).
Main Results:
- Lymphocyte proliferative response was significantly reduced in children with CRI and CRF compared to controls.
- CRF patients on hemodialysis exhibited a significantly lower proliferative response than CAPD patients.
- These findings indicate a depression in cellular immune response in pediatric patients with renal failure.
Conclusions:
- Pediatric patients with chronic kidney disease exhibit impaired cellular immune function.
- The type of renal replacement therapy may influence the degree of immune depression in children with CRF.
Abstract:
We used mixed lymphocyte culture (MLC) as an assay to evaluate in vitro the cellular immune functions of children with chronic renal insufficiency (CRI) or with chronic renal failure (CRF). The proliferative response of lymphocytes from both groups of patients was significantly reduced as compared to the response of control individuals. In addition, the proliferative response of CRF patients treated with hemodialysis was significantly lower than the response of continuous ambulatorial peritoneal dialysis (CAPD) patients. These data confirm that a marked depression of the cellular immune response is detectable in a pediatric population, as predicted from data from the literature on the adult renal failure population.