The frequency of Th2 type cells increases with time on peritoneal dialysisin patients with diabetic nephropathy

We have analysed the frequency of cytokine-producing T cells in different d ialysis groups (haemodialysis; HD and peritoneal dialysis; PD) over time. A lthough we saw no difference in type 1 cytokine production (IL-2 and IFN-ga mma) in either dialysis group, there was a clear increase in the percentage of T cells spontaneously producing the type 02 cytokines in the PD group ( IL-4, r = 0.558, P < 0.05; IL-10, r = 0.527, p < 0.05), Our patient group w as carefully selected to include patients with an ongoing autoimmune diseas e, insulin dependent diabetes mellitus (IDDM) (DN group) and chronic glomer ulonephritis (GN), which are common reasons of end stage renal failure, As expected there was no increase in the spontaneous production of either IL-4 or IL-10 in either disease group with patients undergoing HD treatment. Ho wever, there was a clear correlation with the frequency of T cells producin g IL-4 (r = 0.755, P < 0.05) and IL-10 (r = 0.725, P < 0.05) and time on di alysis in the PD patients with DN, but not those with GN, Much work has sug gested that the pathogenesis of IDDM is associated with a Th1 dominated res ponse. We show here that this response is skewed towards a Th2 response aft er long term treatment with PD, This work demonstrates that the immunologic al effects of different dialysis modalities on patients with different dise ases vary. This may go some way to explain why certain patient groups have more complications with different dialysis modalities.