The relationship between lymphocyte subsets, nutritional status and tuberculin reactivity in continuous ambulatory peritoneal dialysis and hemodialysis patients

Abstract

Aim Skin test anergy is common in patients with uremia and during maintenance hemodialysis treatment. However, up to date only one study concerning skin test in peritoneal dialysis patients has focused on the issue. Our cross-sectional controlled study was conducted to analyze the correlation of purified protein derivative (PPD) test response with demographical features, nutritional parameters and the distribution of peripheral blood lymphocyte subsets in peritoneal dialysis and hemodialysis patients Patients and methods Stable 30 hemodialysis (HD) patients (16 men, 14 women) and 30 continuous ambulatory peritoneal dialysis (PD) patients (17 men, 13 women) were included. Thirty healthy cases (15 men, 15 women) with a mean age of 32.4 ± 9.4 constituted the control group. Results In the HD group, 14 patients (46.6%) were PPD positive, and ın the PD group 16 patients (53.3%) were PPD positive. In the PPD-positive HD patients 64.2% (9/14), and in the PPD-positive PD patients 62.4% (10/16) had an induration of 10 mm or greater. In the control group, 21 of 30 patients (70%) were PPD positive. Comparison of both HD and PD groups with the control group showed significant differences in PPD reactivity (p < 0.01). Albumin levels were significantly high in the control groups (p < 0.01), and cholesterol levels were significantly high in the PD and the control groups (p < 0.05). Transferrin levels were significantly high in the PD (p < 0.01). The lymphocyte counts were significantly high in the control group compared to the HD patients (p < 0.05). The lymphocyte subset percentages CD19 were high in the control groups (p < 0.05), and CD16/56 was significantly high in the PD groups (p < 0.05). All the parameters were also similar between PPD-positive and-negative same groups. Conclusion The prevalence of PPD positivity was lower in the PD and HD groups. The PPD test responses were not related to the peripheral lymphocyte counts, subsets and malnutrition parameters.

Oxidative Stress in Patients with Advanced CKD and Renal Replacement Therapy: The Key Role of Peripheral Blood Leukocytes

“…Interestingly, HD patients also had a marked reduction of CD4+ T-lymphocytes and NK cells than NDD-CKD patients, whereas PD patients had lower B-cell counts. Our results are in agreement with other studies in which dialysis patients exhibited a high incidence of lymphopenia affecting T-and B-cell populations [46,63,64]. The decreased CD4+ T-cells proportion could promote infection and mortality in HD patients [63].…”

“…We found remarkable changes with respect to MNs populations (mainly lymphocytes), but not in PMNs (>98% were neutrophils in all groups; data not shown). In several studies, lymphocyte subgroups were lower in dialysis patients than in healthy controls [63,64]. In our study, T-and B-cells were also influenced by dialysis modality.…”

“…An optimal redox state is essential for the effectiveness of the immune functions, which can also be influenced by the changes in the leukocyte populations in terms of the cell types composition, quality and proportions [9,10]. Much evidence indicates that lymphocytes impairment is also involved in immune dysregulation in ESRD patients [46,63,64]. We found remarkable changes with respect to MNs populations (mainly lymphocytes), but not in PMNs (>98% were neutrophils in all groups; data not shown).…”

Clinical Observation on the Nursing Effect of Mindfulness-Based Stress Reduction Combined with Solution-Focused Brief Therapy in Uremic Peritoneal Dialysis Patients and Influence on Nutritional Status

“…In addition, most patients with uremia will have varying degrees of malnutrition before undergoing PD, mainly including hypoproteinemia, hyperphosphatemia, and anemia. After uremia patients receive PD treatment, although the degree of malnutrition is significantly improved compared with that before dialysis, the patients still suffer from malnutrition, which may increase the risk of cardiovascular events and death in the long-term [ 6 ]. Therefore, how to improve the therapeutic effect and nutritional status of uremia patients undergoing PD has become one of the hot issues in the medical field.…”