Studies on Depression of Immunological Capacity and Metabolic Bone Disease in Patients in Long-term Hemodialysis : I. The Depression of Immunological Capacity in Patients on Long-term Hemodialysis

The effect of long-term hemodialysis on the immunological status was investigated in 54 patients with chronic renal failure. These patients received medical treatment at the Yamaguchi Rosai Hospital from March, 1970 to April, 1979. Their ages ranged from 13 to 72 years (Mean=47years). The underlying renal diseases are summarized in Table 1. Several parameters of immune response, such as peripheral blood lymphocyte count, tuberculin skin test, PHA skin test, differential count of lymphocyte subpopulation, count of phytohemagglutinin (PHA) induced blast cells and serum immunoglobulin level, were assessed in these patients. The chief results obtained are as follows. 1. The mean values of individual parameters in the patients were decreased compared with those in healthy subjects, except for the immunoglobulin levels. This suggested a depression in the cell-mediated immunity in patients with chronic renal failure. 2. The absolute lymphocyte count and percentage tended to increase after initiation of hemodialysis, but it was not an effective improvement and there was no relationship between the absolute lympbocyte count and the duration of the hemodialysis. 3. With the initiation of hemodialysis, the reactivity to the tuberculin skin test increased, but after the lapse of one year it started to decrease again. The PHA skin test reaction tended to increase slightly 1 to 2 years after the initiation of hemodialysis. 4. The absolute number of E-rosette forming cells (E-RFC) slightly increased 1 to 2 years after the initiation of hemodialysis, but decreased again later. 5. The percentage of PHA induced blast cells was also somewhat increased after initiation of hemodialysis, but the reactivity tended to decrease again one year after hemodialysis.