Cytokine production and cytotoxicity of lymphocytes in patients on maintenance short- or long-term haemodialysis.

The lymphocyte-mediated cytotoxicity and cytokine production of patients under maintenance haemodialysis were studied. The patients were subdivided into two groups; 27 patients receiving haemodialysis treatment for up to 3 years (group 1) and 27 patients for longer than 10 years (group 2). Twenty-six healthy volunteers (group 3) were used as controls. The immunological parameters assayed were NK cell and lymphokine-activated killer (LAK) cell activities, and production of both interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha by either peripheral blood mononuclear cells (PBMC) cultured with IL-2 or LAK cells. In group 1 both NK- and LAK-cell-mediated cytotoxicities were significantly suppressed as compared to those in group 3. The titre of IFN produced by LAK cells was also less than that in group 3. On the contrary there were no significant differences in cytokine production by PBMC in all three groups. Percentage of the cases with suppressed cytokine production seemed higher in group 1 than group 3. In addition there was a close correlation between the value of IFN-gamma and of TNF-alpha produced by PBMC in the patients on haemodialysis. Both the type of dialysis membranes used and the primary diseases did not significantly influence the results in group 1 and group 2. From these results it could be speculated that there are more patients with impaired immune function in group 1 than in group 3. In contrast there was no significant difference in the immune function tested between group 2 and group 3.(ABSTRACT TRUNCATED AT 250 WORDS)