EPIDERMAL LANGERHANS CELLS IN UREMIC PATIENTS ON HEMODIALYSIS OR CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

Skin biopsies of 33 uremic patients - 13 patients on continuous ambula tory peritoneal dialysis (CAPD), 12 on hemodialysis (HD), 8 patients w ith end-stage renal disease (ESRD) before initiation of dialysis treat ment - and 10 healthy volunteers were investigated to determine the nu mber of Langerhans cells (LC) by light microscopy after staining for S -100 protein. The epidermal LC count was significantly lower in patien ts on CAPD (mean: 62.9 LC/mm2; p = 0.027) and patients on HD (mean: 30 .4 LC/MM2; p = 0.0015) compared to controls (mean: 110.1 LC/mm2) and u remic patients before initiation of dialysis treatment (mean: 122.6 LC /mm2). The difference between LC counts of CAPD and HD patients did no t reach statistical significance (p = 0.057). There was no relation be tween LC count and age (p = 0.057) or epidermal width (p = 0.26). No s tatistically significant correlation could be demonstrated between dur ation of dialysis and LC count (r = -0.33, p = 0.10). LC counts of CAP D patients with diabetes mellitus (n = 7) were not significantly diffe rent from those of nondiabetics (n = 6; p = 0.77). LC counts seem to b e normal in uremic patients before dialysis treatment. The reduction i n LC density in the skin of dialysis patients may contribute to immuno deficiency of uremic patients on regular dialysis treatment.