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Aging and End Stage Renal Disease Cause A Decrease in Absolute Circulating Lymphocyte Counts with A Shift to A Memory
Geraldo Rubens Ramos Freitas1,2, Maria da Luz Fernandes2, Fabiana Agena2
11Division of Nephrology, and.
Aging and Disease
|February 2, 2019
Summary
Aging and end-stage renal disease (ESRD) both decrease lymphocytes in kidney transplant candidates. While aging increases regulatory T cells, ESRD decreases them, necessitating tailored immunosuppression for elderly recipients.
Area of Science:
- Immunology
- Nephrology
- Transplantation
Background:
- Elderly kidney transplant recipients are increasing, facing higher risks of infection and malignancy despite lower rejection rates.
- Aging and chronic kidney disease (CKD) significantly impact the immune system, potentially altering transplant outcomes and immunosuppression needs.
Purpose of the Study:
- To analyze the distinct and combined effects of aging and end-stage renal disease (ESRD) on peripheral lymphocyte subsets in kidney transplant candidates.
- To inform the development of optimized immunosuppression strategies for elderly kidney transplant recipients.
Main Methods:
- Compared naïve, memory, and regulatory T and B lymphocytes in four groups: healthy adults, healthy elderly, adult ESRD patients, and elderly ESRD patients.
- Utilized flow cytometry to quantify lymphocyte populations prior to kidney transplantation.
Main Results:
- Both aging and ESRD caused an additive decrease in absolute lymphocyte counts, affecting naive, memory, and regulatory subsets.
- Aging increased the percentage of T memory cells and regulatory T cells (TREG), while ESRD increased T memory cells but decreased TREGs.
- Combined aging and ESRD elevated regulatory B cell percentages, alongside global lymphopenia and a TCD4+ memory shift.
Conclusions:
- Aging and ESRD have distinct, additive impacts on immune cell profiles, particularly T regulatory cells.
- The contrasting effects of aging (increasing TREGs) and ESRD (decreasing TREGs) highlight the need for individualized immunosuppression protocols in elderly kidney transplant recipients.
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