Journal Article

The effects of chronic kidney disease and renal replacement therapy on circulating dendritic cells

Dennis A. Hesselink, Michiel G. H. Betjes, Martijn A. Verkade, Petros Athanassopoulos, Carla C. Baan and Willem Weimar

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 20, issue 9, pages 1868-1873
Published in print September 2005 | ISSN: 0931-0509
Published online May 2005 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfh897
The effects of chronic kidney disease and renal replacement therapy on circulating dendritic cells

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Background. The mechanisms underlying the immunodeficiency of chronic kidney disease (CKD) are incompletely understood. Recently, we described decreased numbers of myeloid (m) and plasmacytoid (p) dendritic cells (DCs), considered the most important antigen-presenting cells, in peripheral blood of patients on chronic intermittent haemodialysis (CIHD). In this study, we analysed whether this reduction resulted from CKD or from renal replacement therapy (RRT).

Methods. Using flowcytometry, we quantified mDCs and pDCs in peripheral blood of patients maintained on CIHD (n = 37), continuous ambulatory peritoneal dialysis (CAPD; n = 29), and patients with CKD not receiving RRT (n = 37). Twenty-nine healthy volunteers served as controls.

Results. Patients with CKD (n = 103) had lower pDC and mDC counts compared with volunteers: 4.2 vs 8.3 and 10.0 vs 13.8×106 cells/l, respectively (P ≤ 0.001). Within the CKD group, pDC counts did not differ between patients on CIHD, CAPD and those not receiving RRT (3.6 vs 5.0 vs 4.9×106 cells/l, respectively). In the latter group, pDC numbers correlated with the glomerular filtration rate (GFR; Spearman's r = 0.49; P<0.01). In contrast, mDC counts of patients on CIHD were lower compared with patients on CAPD (7.5 vs 10.1×106 cells/l; P = 0.039) and patients not receiving RRT (13.7×106 cells/l; P<0.001). Among non-dialyzing patients, no correlation existed between GFR and mDC numbers, which were comparable to those of volunteers, even when only non-dialyzing patients with a GFR below 15 ml/min were analysed.

Conclusions. Circulating DC counts are decreased in patients with CKD; for pDCs, this reduction is primarily related to the loss of GFR, whereas the dialysis treatment appears to affect mDC numbers.

Keywords: chronic haemodialysis; chronic kidney failure; chronic renal disease; continuous ambulatory peritoneal dialysis; immunodeficiency; renal replacement therapy

Journal Article.  3698 words.  Illustrated.

Subjects: Nephrology

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