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Abstract: FR-PO879

Sex-Based Immunological Disparity in ESRD Patients

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular


  • Yang, Feng-Jung, National Taiwan University, Taipei, Taiwan
  • Chiu, Yen-Ling, National Taiwan University, Taipei, Taiwan

Sex differences in the immune response and in infectious disease susceptibility have been well described, although the mechanisms underlying these differences remain incompletely understood. Patients with end-stage renal disease may face higher risk of infection. The activity and distribution of T cell and monocyte subsets between the sexes is still unknown.


The immunity in ESRD study (iESRD) recruited 412 hemodialysis patients from both northern and southern Taiwan. Peripheral blood were sampled before hemodialysis session and processed immediately for mononuclear cell isolation and staining. Using multicolor flow cytometry, lymphocytes were separated into subpopulations including naive Tn cells, central memory TCM, effector memory TEM, and terminally differentiated TEMRA. Monocytes were separated into three groups M1 M2 M3. Plasma levels of high-sensitivity C reactive protein was determined.


Among CD4+/CD8+ T cell subsets, male patients showed decreased percentage of naïve CD4+/CD8+ Tn cell and increased percentage of effector memory CD4+/CD8+ TEM. Among monocytes subset, female patients showed increased percentage of classical monocytes and decreased percentage of nonclassical monocytes CD14+CD16+ monocytes. The M1 percentage of ESRD was lower than general population ~80%. Low M1 and high M3 indicating more inflammatory response in the this group. Besides, female patients have more numbers of naïve CD4+/CD8+ Tn cell and central memory CD8 TCM but less numbers of nonclassical monocytes M3.


Males and females differ in innate and adaptive immune responses. These sex-based immunological disparities contribute to variations in the incidence of autoimmune diseases and malignancies, susceptibility to infection. Our study showed the immune age of female was younger than male in ESRD. Male have more ‘Non-classical’ subtype monocytes which display more ‘inflammatory’ characteristics Sex associated immune response should be further investigated in the pathogenesis of infection and aging in ESRD.