Acute effects of dialysis on T lymphocytes in patients with end-stage renal disease.

The acute effect of dialysis on T-lymphocyte responses was studied in 11 patients with end-stage renal disease (ESRD). The in-vitro mitogenic response to concanavalin A and pokeweed mitogen was decreased (p less than 0.05) after single passage of blood through the dialyzer, accompanied by a reduction in the proportion of monoclonal antibody-defined total T lymphocytes (Leu 1+ cells) (p less than 0.01), an increase in the percentage of monoclonal antibody-defined monocytes (M 2+ cells), and a decrease in interleukin 2 (IL-2) production (p less than 0.05). Depletion of adherent cells from mononuclear cells isolated from blood after single passage through the dialyzer restored the mitogenic responses to normal levels. Post dialysis mitogenic responses were comparable to pre-dialysis mitogenic responses although IL-2 production (p less than 0.05), and the proportion of T lymphocyte (Leu 1+ cells) remained depressed (p less than 0.01). Cumulative effects of long-term intermittent hemodialysis may contribute to the impaired immunity and the increased frequency of infections and neoplasms in patients with end-stage renal disease.