Antibodies to nuclear antigens in patients with renal failure.

Nuclear material, presumably from damaged leukocytes, adheres to hemodialysis membranes. Previous studies have shown an increased prevalence of antibodies to nuclear antigens in chronic dialysis patients. Present studies verify the increased prevalence of antibodies to nuclear antigens in 52 of 243 chronic dialysis patients (21.4%). Because antibodies are present only intermittently, prevalence increases with repetitive blood sampling. In patients tested every 3 months over several years on chronic dialysis, the prevalence of antinuclear antibodies approaches 100%. The present studies also demonstrate, however, that the prevalence of antibodies is increased in patients with renal failure who have never undergone hemodialysis (10 of 86, 11.6%). Thus the tendency to form antibodies to nuclear antigens may be associated with renal failure rather than dialysis per se. Higher prevalences with increased time on dialysis and transplantation failure may accordingly reflect the greater duration of renal failure. The prevalence of antibodies to nuclear antigens was not significantly influenced by age, sex, type of kidney disease, major blood group, HLA tissue type, or coil reuse. Significantly lower hematocrits and white blood counts were noted when antibodies were present.