Abstract: 【Abstract】 Objective The clinical relevance of altered lymphocyte function to uremic toxins, such as higher parathyroid hormone (PTH), is not well understood. We studied the changes of B- and T-cellular immunity in end stage renal disease (ESRD) patients with hemodialysis (HD), and evaluated the relationship between T-lymphocyte function and plasma PTH level. Methods Blood cell analysis was conducted in 257 ESRD patients. Patients were divided into 3 groups based on treatment and PTH level: chronic kidney disease (CKD) patients without dialysis (n=20), HD patients with higher PTH (>300pg/ml, n=12), and HD patients with lower PTH (<300 pg/ml, n=11). Lymphocyte subsets were quantified in the 3 groups using monoclonal antibodies and flow cytometry. Analysis of variance (ANOVA) and Pearson correlation analysis using SPSS version 10.0 were performed to test the differences between the 3 groups. Results (a) The percentage of Lymphocytes decreased in 47.5% (122/257) ESRD patients, but the white blood cell count decreased in only 3.9% of the 257 patients. (b) When comparisons were made between ESRD patients with HD and CKD patients without HD, lymphocyte count (1367.4±650.4 vs. 1942.3±856.3, P<0.05), CD19+ B-cells (114.0±88.2 vs. 229.3±143.3, p<0.001), and CD3+ T-cells (1035.9±497.4 vs. 1483.4±674.1, P<0.05) were lower in ESRD patients with HD, in association with the lower percentage and cell count of CD4+ T-cells, CD8+ T-cells and CD28+ cells. (c) CD19+ cells decreased significantly in HD patients with lower PTH (<300 pg/ml). Conclusion T-cell and B-cell functions are abnormal in ESRD patients with HD. Serum PTH level may affect B-cell function.

Key words: Lymphocyte subgroup, PTH