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Abstract: SA-PO939

Innate Immunity Dysfunction: A Prospective Study on Peritoneal Dialysis and Hemodialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Figueiredo, Ana Carolina, Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
  • Leal, Rita, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  • Sa, Helena Oliveira, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Background

The immunological disorder associated with chronic kidney disease is complex since there is a coexistence of a proinflammatory state and immunological deficiency, both contributing to patients’ morbidity and mortality. The immune dysfunction on end-stage renal disease covers both innate and adaptive immunity, although disturbances in the innate branch are far less described in the literature. The aim of the present work is to study the innate immune system changes in patients undergoing hemodialysis and peritoneal dialysis, and if significant residual renal function influences innate immunity.

Methods

A prospective, case-control study was performed using peripheral blood samples from 21 patients undergoing PD, 20 patients undergoing HD and 12 healthy patients. Whole blood cells were analyzed and quantification of leukocyte subpopulations and surface molecules was made by flow cytometry using different fluorescent antibody conjugates.

Results

There was a significant decrease in monocytes and dendritic total cell counts in dialysis patients compared to healthy controls. Natural killer cells in hemodialysis patients, compared to peritoneal dialysis and controls, had enhanced expression of the receptors NKp30, NKp44, CD94/NKG2C, and IFNg, indicating enhanced cytokine production, and increased expression of CD57. Hemodialysis patients also presented more pro-inflammatory markers in iNKT and gdT cells than peritoneal dialysis patients.

Conclusion

Our study suggests an innate immunity dysfunction in dialysis patients, more evident in hemodialysis patients that express a proinflammatory profile and chronic activation of the innate immunity system.