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The immunological state in chronic renal insufficiency
The International Journal of Artificial Organs
|July 1, 1982
Summary
Cell-mediated immunity is impaired early in chronic renal failure, even before end-stage disease. Hemodialysis does not improve this cell-mediated immunodeficiency in patients with chronic kidney disease.
Area of Science:
- Immunology
- Nephrology
- Clinical Medicine
Background:
- Chronic renal insufficiency (CRI) affects multiple organ systems, including the immune system.
- Understanding the immunological state in CRI is crucial for patient management and treatment strategies.
Purpose of the Study:
- To evaluate the cellular and humoral immunological status in patients with varying stages of chronic renal failure.
- To determine if hemodialysis influences the observed immunological changes in CRI.
Main Methods:
- Studied 292 patients with chronic renal failure, categorized by creatinine clearance levels and hemodialysis treatment.
- Assessed cell-mediated immunity using DNCB and PPD skin tests, and rosette assays (spontaneous, active, EAC).
- Evaluated humoral immunity through surface membrane immunoglobulin tests, complement levels (C3, C4), and serum immunoglobulins.
Main Results:
- Cell-mediated immunity was significantly impaired in patients with terminal renal insufficiency and those on hemodialysis.
- Marked reduction in cell-mediated immunity was also observed in patients with non-terminal renal insufficiency.
- Humoral immunity showed less significant changes; B lymphocyte counts and serum immunoglobulins were normal, but C3 levels were below normal.
Conclusions:
- Cell-mediated immunodeficiency is an early manifestation of chronic renal failure, preceding end-stage disease.
- Hemodialysis treatment does not appear to ameliorate the cell-mediated immune deficiency associated with chronic renal failure.