Abstract: SA-PO839

Lymphopenia CD19+, a New Cardiovascular Risk Factor in Hemodialysis Patients

Session Information

Category: Dialysis

  • 606 Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular

Authors

  • Molina, Maria, Hospital Universitario 12 de Octubre, Madrid, Madrid, Spain
  • Morales, Enrique, Hospital Universitario 12 de Octubre, Madrid, Madrid, Spain
  • Yuste, Claudia, Hospital Universitario 12 de Octubre, Madrid, Madrid, Spain
  • Praga, Manuel, Hospital Universitario 12 de Octubre, Madrid, Madrid, Spain
Background

Cardiovascular disease (CVD) is one of the most important causes of mortality in hemodialysis patients (HD). Traditional factors for CVD aren’t good predictors of events. On the other hand, uraemia in HD induce have a proinflamatory environment that facilitate atheromatous lesions. Recently, the role of CD19+ lymphocytes in atheromatosis process has been described in non-uremic patients. The role of CD19+ lymphocytes in CVD in HD patients is unknown.

Aim: To evaluate the role of lymphocytes CD19+ in cardiovascular deaths in HD patients.

Methods

A single centre prospective cohort study was started in 2011. We measured the lymphocytes CD19+ in 104 patients on HD and we followed them for 5 years, death or change the renal replacement therapy (kidney transplantation or peritoneal dialysis). We studied the influence of lymphocytes CD19+ in CDV mortality; other causes of death were censored.

Results

The mean age was 64.8±15 y, 51% were male. Cardiovascular risk factors as arterial hypertension, diabetes mellitus and dyslipidaemia were found in 76%, 29.8% and 51.9%, respectively. 62 (60%) patients had previous CVD: 28% (29) ischemic heart disease, 14.5% (15) stroke and 25% (26) peripheral vascular disease. The follow up were 18 (7-47) months and 55 patients died. 22 patients (40% of all deaths) died for CVD. Multivariable analysis showed the variables associated with CDV mortality: age (HR: 1.04 (95% IC 1.006-1.1), p=0.02), Charlson index (HR: 1.16 (95% IC 1.02-1.3), p=0.02), previous ischemic heart disease (HR: 3.5 (95% IC 1.4-9), p=0.008), lymphocyte CD19+ < 100 cells/µL (HR: 4.1 (95% IC 1.18-14.6), p=0.02) and previous immunosuppression therapy (HR: 0.17 (95% IC 0.06-0.5), p=0.001).

Conclusion

Low CD19+ lymphocyte could be a new cardiovascular risk factor as important as ischemic heart disease in HD patients. To improve the immunological knowledge could decrease the CVD deaths of the HD patients. It is mandatory to performed more studies about the role of CD19+ lymphocyte in CVD in uremic patients.