CELLULAR iMMUNE F(JNCTION IN PATIENTS 'WITH CHUONIC RENAL FAILURE

Abstract

Patients with chronic renal failure show a state of immunodeficiency characterized by infectious complications and a low response to vaccinations. Various abnormalities of immune system have been demonstrated in patients with ESRF. Furthermore, the impaired cellular immune response observed does not seem to be improved once HD is started. Indeed, chronic HD patient have clinical evidence of impaired lymphocyte function. This immunodeficiency not only results from uremic state but also enhanced by HD.

The meChanisms of immunosuppression•in uremia and chronic HD are not fully elucidated. T cells seem to play a.criticaLrole, and it has been suggested that feduced T cell count and impaired T cell proliferation could account for immunodeficiency -in the renal :patients. Dialysis has been associated with acute changes in the romplement activation status, granulocyte mafkers, macrop•hage function, T-cell activation and release of proinflammatory cytokines. T cell cytokines play a maJor role in the impaired lymphocyte function in dialysis patients.

The aim of the present study is to elucidate the respective role ofT­ helper cell subpopulation in understanding mechanisms of uremia-related immune dysregulation in patients with ESRF and to assess the levels of circulating inflammatory cytokines in comparison with controls, and to assess the effect of liD treatment on the immune response of patients with ESRF.