Alterations in T lymphocyte subsets and mitochondrial-related parameters in patients with chronic kidney disease

To investigate the association between renal function and T lymphocyte subsets and mitochondrial-related parameters in patients with chronic kidney disease (CKD).

This retrospective study included patients with CKD between July 2023 and June 2024. Disease stage was assessed based on estimated glomerular filtration rate (eGFR), and patients were classified into CKD stages 1-5 accordingly. Peripheral blood samples were analyzed by flow cytometry to assess T lymphocyte subsets and mitochondrial-related parameters, including mitochondrial mass (MM) and the percentage of cells with low mitochondrial membrane potential (MMP-Low%).

A total of 802 patients with CKD were included (440 males; mean age 56.3 ± 16.0 years), comprising 226 stage 1, 204 stage 2, 205 stage 3, 82 stage 4, and 85 stage 5 cases. Lymphocyte percentage was lower and neutrophil percentage higher in stage 5 vs. stages 1-2 (both p < 0.001). Absolute counts of CD45⁺, CD3⁺, CD4⁺, and CD8⁺ T cells were significantly lower in stages 3-5 vs. 1-2 (all p < 0.05). Mitochondrial alterations in stages 3-5 included decreased MMP-Low% across CD3⁺, CD4⁺, and CD8⁺ subsets (all p < 0.05). After multivariable adjustment, eGFR was independently associated with CD3⁺ T-cell MMP-Low% (β = 0.0375, p = 0.024) and CD8⁺ T-cell MMP-Low% (β = 0.0826, p < 0.001), whereas the association with CD8⁺ T-cell MM was no longer statistically significant.

Reduced T lymphocyte counts and alterations in mitochondrial-related parameters, particularly membrane potential-related parameters, were observed in patients with CKD and were associated with more advanced CKD stages.