Derangement of humoral immune system in nondialyzed uremic patients

To evaluate the humoral immune system in patients with chronic renal failure, a cytological approach was taken. The uremic lymphocytes and their subsets in the peripheral blood were quantitated and their functions studied. In order to exclude the possible effects of extra-uremic factors, the lymphocytes were obtained from the uremic patients with serum creatinine levels of 8 mg/dl or more, and who had been submitted neither to blood transfusions nor dialysis therapy. Absolute numbers of PBL, T cells, B cells, null cells and double marker cells were decreased in uremic patients compared to healthy controls (p less than 0.001), although the percentages of each cell subset of the patients were the same as with the healthy controls. In vitro plaque forming cell responses and DNA synthesis by uremic lymphocytes, stimulated with pokeweed mitogen, were significantly lower than those of the healthy controls. These data point to B lymphocyte as well as T lymphocyte dysfunction in uremia, which may be causally related to the uremic state itself.