Cellular immunity in renal failure: depression of lymphocyte transformation by uraemia and methylprednisolone. Intra-individual consistency of lymphocyte responses to the in vitro suppressive effect of steroid.

In vitro parameters of the cell-mediated immunity were assessed in patients with chronic renal failure on haemodialysis (HD). The in vitro mitogen responses of uraemic lymphocytes are depressed compared to control lymphocyte cultures. Prolonged or shortened incubation of uraemic cultures does not normalize the mitogen responses, and the difference is reflected in both DNA, RNA and protein synthesis of lymphocytes. Lymphocyte responses of control cultures incubated with uraemic plasma are similar to those of cultures with saline, and significantly stronger (p less than 0.05) than those of the uraemic lymphocyte cultures. The relative in vitro immunosuppressive effect of steroid is stronger in uraemic cultures. Thus the depressed uraemic lymphocyte responses may be associated with steroid-sensitive cellular interactions independent of incubation periods. However, both control and uraemic lymphocyte cultures have a reproducible individual in vitro lymphocyte response to the immunosuppressive effect of steroid.