Immunological features of ESRD patients undergoing hemodialysis of various ages

• Published in: International urology and nephrology Vol. 56; no. 1; pp. 313 - 323
• Main Authors: Chen, XiaoHong, Xiang, FangFang, Cao, XueSen, Lv, WenLv, Shen, Bo, Zou, JianZhou, Ding, XiaoQiang
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.01.2024; Springer Nature B.V
• Subjects: Age; CD8 antigen; CD8-Positive T-Lymphocytes; Cell survival; End-stage renal disease; Hemodialysis; Humans; Immunology; Kidney diseases; Kidney Failure, Chronic - therapy; Lymphocytes; Lymphocytes T; Medicine; Medicine & Public Health; Nephrology; Nephrology - Original Paper; Renal Dialysis; T-Lymphocyte Subsets; Urology; Immune alterations; Age effect; Peripheral T cells; End-stage renal disease (ESRD); Hemodialysis (HD); Survival
• ISSN: 1573-2584; 0301-1623; 1573-2584
• DOI: 10.1007/s11255-023-03683-1

Aims To investigate the immunological characteristics of hemodialysis (HD) patients with end-stage renal disease (ESRD) of various ages, and the impact of age-related immune alterations on these patients, with a focus on peripheral T cells. Methods From September 2016 to September 2019, HD patients were enrolled and followed prospectively for 3 years. Patients were divided into three groups based on their ages: < 45, 45 to 64, and ≥ 65. The distribution of T cell subsets in different age groups was investigated and compared. The effects of altered T cell subsets on overall survival were also investigated. Results A total of 371 HD patients were enrolled. The reduced number of naive CD8+ T cells ( P  < 0.001) and increased number of EMRA CD8+ T cells ( P  = 0.024) were independently associated with the advanced age among all T cell subsets studied. Patient survival may be affected by numerical changes in naive CD8+ T cells. However, when HD patients were < 45 or ≥ 65 years, the reduction had no significant impact on survival. Only in HD patients aged 45 to 64 years, the number of naïve CD8+ T cells found to be insufficient but not deficient, identified as an independent predictor of poor survival. Conclusions The most significant age-related immune change in HD patients was a decrease in peripheral naive CD8+ T cells, which was an independent predictor of 3-year overall survival in HD patients aged 45 ~ 64 years.