Lower absolute numbers of CD4 naïve and CD8 effector memory cells in peripheral blood are potential predictive indicators of renal endpoint events in patients with chronic kidney disease.

There is no consensus on the distribution of T cell subsets during chronic kidney disease (CKD) progression. In this study, we aimed to investigate the levels of circulating T cell subsets in the peripheral blood of patients with CKD at various stages and the relationship between T cell parameters and renal endpoint events. We selected 130 patients with non-dialysis stages I-V CKD and 75 healthy controls from Dongyang People's Hospital between February 2021 and March 2023. Multicolor flow cytometry was used to detect T cell subsets in patients at different stages of CKD. The absolute CD4 and CD8 naïve T (TN)/central memory T (TCM), CD8 effector memory T (TEM), and CD8 terminally differentiated effector memory T cell counts in patients with stage V CKD were significantly lower than those in healthy controls. Compared with patients with early-stage CKD, those with advanced CKD stages had altered T cell expression patterns. The incidence of renal events during the follow-up period was 34.62%. CD4TN cell counts ≥ 157/µL and CD8TEM cell counts ≥ 59/µL were independent protective factors for adverse renal outcomes. Our results showed that a decrease in CD4TN and CD8TEM cell counts in the peripheral blood was closely associated with the occurrence of renal adverse events in patients with CKD and may be a potential new prognostic indicator.