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Abstract: SA-PO937

T Regulatory Cells in Uremia: Effect of the First Peritoneal or Hemodialysis Treatment

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Caprara, Carlotta, IRRIV, Vicenza, Italy
  • Corradi, Valentina, San Bortolo Hospital, Vicenza, Italy
  • Sharma, Rahul, University of Virginia, Charlottesville, Virginia, United States
  • Scalzotto, Elisa, IRRIV, Vicenza, Italy
  • de Cal, Massimo, San Bortolo Hospital, Vicenza, Italy
  • Ronco, Claudio, University of Padova, IRRIV, San Bortolo Hospital, Vicenza, Italy
Background

A major challenge for the immune system is to preserve tolerance to self while maintaining the ability to fight foreign pathogens and infectious agents. This function is largely performed by the FOXP3+ T-regulatory (Treg) cells. In the literature, contrasting results have been reported about the influence of dialysis on Treg cells, in chronic kidney disease stage G5 (CKD G5) patients that show activated but impaired immune system. The aim of this study is to evaluate the changes in Treg cells numbers before and after the first dialysis treatment.

Methods

Peripheral blood samples for this pilot study were obtained from 21 CKD G5 patients not yet on dialysis (CKD G5): 8 started hemodialysis (HD, N = 8), 13 started peritoneal dialysis (PD, N = 13). Treg were studied by flow cytometry using CD3-PerCP; CD4-FITC; CD25-PECy7; CD127-PE and FOXP3-APC antibodies.
Time point: T0 (before the first dialysis treatment); T1 (after 1 month).
We performed Wilcoxon test for dependent samples to compare the mean percentage difference between T0 and T1 (Δ %): (100*(T1-T0)/T0).

Results

The total cohort (8HD and 13PD, n = 21) included 88.9% and 77% males in HD and PD groups respectively. Mean age was 68 in HD group and 67 in PD group.
The proportion of lymphocytes and T lymphocytes did not change before and after the first dialysis treatment (as evaluated 1 month after the start of dialysis) in PD and HD patients.
Treg cells (considered either as CD25+FOXP3+, Foxp3+ or CD25+CD127+) analyzed as percentage of lymphocytes showed a statistically significant increase post-PD (median=35.92; p=0.0425 for CD25+FOXP3+; median=30.85; p=0.0479 for FOXP3+ and median=23.71; p=0.0215 for CD25+CD127-); The same populations did not change after the first HD session (median=0.07; p=0.843 for CD25+FOXP3+; median=2.32; p=0.945 for FOXP3+ and median=6.69; p=0,742 for CD25+CD127-).

Conclusion

Our study is the first to evaluated the effect of PD or HD treatment on the status of T-regulatory cells to understand their role in immune homeostasis. PD was more effective in increasing Tregs levels when analyzed at one month post dialysis and may contribute to improvement of inflammatory status. Thus, PD may contribute to better outcomes for patients with renal dysfunction by not only restricting inflammation, but also maintaining homeostasis of peritoneal and renal tissues.

Funding

  • Private Foundation Support