CD4+ AND CD8+ T-Lymphocyte counts and serum levels of IgG IgA and IgM in patients with end stage renal disease on haemodialysis and chronic renal failure not on haemodialysis

Abstract

This study was conducted at the Kenyatta National Hospital Renal unit, renal clinic and medical wards to investigate some immunological parameters in non-haemodialysing CRF patients and ESRD on haemodialysis. The parameters studied included CD4+ and CD8+ T-lymphocyte counts and serum concentration of IgG, IgA and IgM. The objective of the study was to find out whether there is a significant difference in the immunological status at the different stages of renal failure as compared to the normal controls. A total of 90 individuals were investigated, comprising of 30 patients with ESRD on haemodialysis, 30 non-haemodialysing CRF and 30 normal controls. Patients diagnosed to have CRF or ESRD who were currently on haemodialysis and normal controls who fulfilled the inclusion criteria were recruited into the study. The individuals investigated were aged between 12 and 60 years, lacked clinical evidence of infection, disease or drug use known to interfere with the immune system. Blood samples were taken (before haemodialysis in cases of ESRD) and the immunological parameters analyzed. A non-parametric data analysis using SPSS computer package was done.

The results revealed aberrant counts of total lymphocytes, CD4+ and CD8+ T-lymphocyte in both non-haemodialysing CRF and ESRD patients on haemodialysis compared to the normal control. These included low lymphocyte count with normal total WBC count, low absolute CD4+ and CD8+ T-lymphocyte count. Serum concentration of IgG, IgA and IgM were normal in the uraemic patients compared to the control group. High CD4+ : CD8+ Tlymphocyte ratio was observed in ESRD patients on haemodialysis as compared to that in non-haemodialysing CRF. It is concluded that non-haemodialysing CRF and ESRD on haemodialysis have reduced lymphocyte count, absolute CD4+ and CD8+ T-lymphocyte count. They both have normal concentration of IgG, IgA and IgM compared to the control group. Higher CD4+: CD8+ T-lymphocyte ratio is observed in ESRD patients on haemodialysis.