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Immunological features of ESRD patients undergoing hemodialysis of various ages

  • Nephrology - Original Paper
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Abstract

Aims

To investigate the immunological characteristics of hemodialysis (HD) patients with end-stage renal disease (ESRD) of various ages, and the impact of age-related immune alterations on these patients, with a focus on peripheral T cells.

Methods

From September 2016 to September 2019, HD patients were enrolled and followed prospectively for 3 years. Patients were divided into three groups based on their ages: < 45, 45 to 64, and ≥ 65. The distribution of T cell subsets in different age groups was investigated and compared. The effects of altered T cell subsets on overall survival were also investigated.

Results

A total of 371 HD patients were enrolled. The reduced number of naive CD8+ T cells (P < 0.001) and increased number of EMRA CD8+ T cells (P = 0.024) were independently associated with the advanced age among all T cell subsets studied. Patient survival may be affected by numerical changes in naive CD8+ T cells. However, when HD patients were < 45 or ≥ 65 years, the reduction had no significant impact on survival. Only in HD patients aged 45 to 64 years, the number of naïve CD8+ T cells found to be insufficient but not deficient, identified as an independent predictor of poor survival.

Conclusions

The most significant age-related immune change in HD patients was a decrease in peripheral naive CD8+ T cells, which was an independent predictor of 3-year overall survival in HD patients aged 45 ~ 64 years.

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Data availability

Data will be available from the corresponding author on reasonable request.

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Acknowledgements

The authors acknowledge the contributions of the other investigators in this study. The Zhongshan Hospital of Fudan University, Shanghai, P. R. China endorsed the study.

Funding

This study was funded by the Shanghai Federation of Nephrology Project supported by the Shanghai ShenKang Hospital Development Center (No. SHDC2202230), Shanghai “science and technology innovation plan” Yangtze River Delta Scientific and Technological Innovation Community project (No. 21002411500), and the Shanghai “science and technology innovation plan” technical standard project (No. 19DZ2205600).

Author information

Authors and Affiliations

  1. Shanghai Institute of Kidney and Dialysis, Shanghai, China

    XiaoHong Chen, FangFang Xiang, XueSen Cao, WenLv Lv, Bo Shen, JianZhou Zou & XiaoQiang Ding

  2. Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China

    XiaoHong Chen, FangFang Xiang, XueSen Cao, WenLv Lv, Bo Shen, JianZhou Zou & XiaoQiang Ding

  3. Hemodialysis Quality Control Center of Shanghai, Shanghai, China

    XiaoHong Chen, FangFang Xiang, XueSen Cao, WenLv Lv, Bo Shen, JianZhou Zou & XiaoQiang Ding

  4. Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China

    XiaoHong Chen, FangFang Xiang, XueSen Cao, WenLv Lv, Bo Shen, JianZhou Zou & XiaoQiang Ding

  5. Shanghai Medical Center of Kidney, Shanghai, China

    XiaoHong Chen, FangFang Xiang, XueSen Cao, WenLv Lv, Bo Shen, JianZhou Zou & XiaoQiang Ding

  6. Blood Purification Center, Zhongshan Hospital of Fudan University, 136 Yi Xue Yuan Road, Shanghai, 200032, People’s Republic of China

    XiaoQiang Ding

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  1. XiaoHong Chen
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Correspondence to XiaoQiang Ding.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The study and protocol were reviewed and approved by the Medical Ethics Committee of Zhongshan Hospital, Fudan University (Approval Number: B2014-083).

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Chen, X., Xiang, F., Cao, X. et al. Immunological features of ESRD patients undergoing hemodialysis of various ages. Int Urol Nephrol 56, 313–323 (2024). https://doi.org/10.1007/s11255-023-03683-1

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  • DOI: https://doi.org/10.1007/s11255-023-03683-1

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