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IgG2 deficiency in uremic children is not restricted to peritoneal dialysis treatment
M J Kemper1, T Meyer-Jark, D E Müller-Wiefel
1Division of Pediatric Nephrology, University Children's Hospital Eppendorf, Hamburg, Germany.
Insights
Children with chronic renal failure (CRF) show a deficiency in IgG2 subclass levels, regardless of whether they are on peritoneal dialysis (PD) or in a preterminal state. This finding highlights alterations in immune function in pediatric CRF patients.
Area of Science:
- Pediatric Nephrology
- Immunology
- Clinical Chemistry
Background:
- Limited data exist on IgG subclasses in children with preterminal chronic renal failure (CRF).
- Previous studies indicated reduced total serum IgG and its subclasses (IgG1, IgG2) in pediatric patients undergoing peritoneal dialysis (PD).
Purpose of the Study:
- To investigate total immunoglobulin G (IgG), IgA, IgM, and IgG subclass levels in children with preterminal CRF and those on PD.
- To compare these levels with age-matched healthy controls and established normal values.
Main Methods:
- Serum samples were analyzed for total IgG, IgA, IgM, and IgG subclasses in preterminal CRF patients (n=25), PD patients (n=22), and healthy children (n=13).
- Results were compared to age-related normal values from a larger cohort (n=226).
Main Results:
- Total IgG, IgA, IgM, and IgG1 levels were comparable across groups.
- A significant deficiency in IgG2 was observed in children with both preterminal CRF and those on PD compared to controls.
- The prevalence of IgG2 deficiency was notably higher in preterminal CRF patients than expected based on age-related normal values.
Conclusions:
- Children with chronic renal failure exhibit significant alterations in serum IgG subclasses.
- IgG2 deficiency is present not only in pediatric patients on PD but also in those with preterminal CRF.
- These findings suggest impaired immune function related to IgG subclass levels in pediatric CRF, extending beyond dialysis-dependent states.
Abstract:
To date there are no data concerning IgG subclasses in children with preterminal chronic renal failure (CRF), although a reduction of total serum IgG, including its major subclasses IgG1 and IgG2, has been demonstrated in patients on peritoneal dialysis (PD). Therefore we studied total IgG, IgA, IgM, and IgG subclasses in preterminal CRF (n = 25), PD (n = 22) patients, and 13 age-matched healthy children and also compared results with age-related normal values previously established in 226 healthy children. While total IgG, IgA, IgM, and IgG 1 were comparable, there was a significant deficiency of IgG2 in children both with preterminal CRF and on PD compared with controls. Moreover, the prevalence of IgG2 deficiency compared with age-related normal values was significantly increased not only in PD but also in preterminal CRF patients. We conclude that there are alterations in serum IgG subclasses in children with CRF, with IgG2 deficiency not restricted to PD, but being present in the preterminal state as well.