One-year immunological evaluation of chronic hemodialysis in end-stage renal disease patients

Background: Much research has been devoted to the determination of acute le ukocyte activation as well as acute cytokines production during and after b lood hemodialysis membrane interaction. In contrast, few studies deal with chronic immunological evaluation of T-cell activation markers in hemodialys is. Methods: We evaluated different immune parameters using a modified cell ulose low-flux hemophan vs. synthetic high-flux polyamide membrane during 1 year in 35 stable chronic hemodialysis patients. Leukocyte counts, lymphoc yte subpopulations, T-cell activation markers (CD69, CD25, HLA-DR, CD54, CD 62L, CD45RO, CD11a, CD28), complement-activation products (C3a) and serum e lastase were measured at 0, 3, 6 and 12 months in the two patient groups an d compared to 13 healthy control subjects. Results: Over dialysis time, all patients showed a significant level elevation of CD69/CD3 (p < 0.005) and CD25/CD3 (p < 0.005) phenotypes. In contrast, HLA-DR and CD45RO remained un changed suggesting a truncated pattern of activation. T lymphocyte subset a nalysis showed in both hemodialyzed groups a significant decrease in the ex pression of CD54 (ICAM-1) when compared to controls (p < 0.005). C3a and el astase measurements showed a significant upward trend with dialysis time in both hemodialyzed groups. Conclusion: Although the immunological changes s een in chronic hemodialyzed patients must be interpreted in conjunction wit h their basal uremic states and the membrane permeability properties, our s tudy suggests that 1-year immunological evaluation of hemodialysis membrane s biocompatibility is associated with changes in the pattern of chronic T-c ell activation, which is in part related to the use of a particular membran e type. Moreover, some key molecules (CD54) are affected in patients with e nd-stage renal disease undergoing hemodialysis. Copyright (C) 2000 S. Karge r AG, Basel.