Impaired neutrophil response to acute bacterial infection in dialyzed patients

The changes in WBC counts during various acute bacterial infections were studied in 11 dialyzed patients. There was substantial leukocytosis in only five of 17 episodes, despite conclusive clinical and bacteriologic evidence that the infection was caused by Gram-positive microorganisms. Segmented neutrophil counts also did not rise in most cases. Nonsegmented neutrophil counts, however, showed the normal expected increase. This blunted response may be another facet of the increased susceptibility of dialyzed patients to infection and may warrant early administration of antimicrobial treatment.