Polymorphonuclear leucocyte function in chronic renal failure and after renal transplantation

Area of Science:

• Immunology
• Nephrology
• Renal Replacement Therapy

Background:

• Chronic renal failure (CRF) significantly impacts immune system function.
• Understanding neutrophil dysfunction is crucial for managing infections in CRF patients.
• Different renal replacement therapies may differentially affect immune responses.

Purpose of the Study:

• To evaluate neutrophil functions (chemotaxis, phagocytosis, bactericidal ability) in patients with CRF.
• To compare immune function across different stages and treatments of CRF: conservative therapy, peritoneal dialysis (PD), hemodialysis (HD), and renal transplantation.
• To assess the role of serum from CRF patients in modulating neutrophil activity.

Main Methods:

• Assessment of neutrophil chemotaxis, phagocytosis, and bactericidal activity.
• Comparison between patients on conservative therapy, PD, HD, and post-renal allograft.
• Evaluation of serum opsonization and chemotactic properties after endotoxin activation.

Main Results:

• Neutrophil chemotaxis was impaired in all patient groups studied.
• Phagocytosis was mildly impaired in patients undergoing PD and HD.
• Bactericidal ability was normal in all groups except for a mild defect in those on conservative therapy. Serum from CRF patients, when activated, showed poor chemotaxis but normal opsonization.

Conclusions:

• Neutrophil dysfunction, particularly impaired chemotaxis, is a common feature across various stages of chronic renal failure and its treatments.
• While PD and HD show mild phagocytic impairment, conservative therapy presents a mild defect in bacterial killing.
• CRF patient serum has altered chemotactic properties but retains normal opsonization capacity for phagocytosis.