Total serum IgE in uremia and after renal transplantation.

Uremic patients on maintenance hemodialysis, but without clinical evidence of atopy or diabetes mellitus, had serum levels of total IgE significantly lower than in healthy controls matched for age and sex. Patients with uremia due to diabetic nephropathy had higher IgE levels than the reference group. No correlation was found between total IgE levels and length of dialysis treatment. After renal transplantation, the IgE levels decreased on average to 31% of the pretransplant values over a 60-day observation period. Bacterial or viral infections or episodes of kidney rejection had no apparent influence on the IgE synthesis in the patients with transplant. No correlation was detectable between pretransplant IgE levels and six-month survival of the kidney graft. The low IgE concentrations in uremia are suggested to reflect altered T-cell regulation of the IgE production. The raised IgE levels in diabetic patients could not be explained by specific reagins against insulin, but may have reflected an influence of abnormal carbohydrate metabolism on IgE synthesis. The fall in IgE levels following transplantation is proposed to be attributable to the combined corticosteroid-azathioprine treatment.