CD4+ AND CD8+ T-Lymphocyte counts and serum levels of IgG IgA and IgM in patients with end stage renal disease on haemodialysis and chronic renal failure not on haemodialysis
Abstract
This study was conducted at the Kenyatta National Hospital
Renal unit, renal clinic and medical wards to investigate some
immunological parameters in non-haemodialysing CRF patients
and ESRD on haemodialysis. The parameters studied included
CD4+ and CD8+ T-lymphocyte counts and serum concentration of
IgG, IgA and IgM.
The objective of the study was to find out whether there is a
significant difference in the immunological status at the
different stages of renal failure as compared to the normal
controls.
A total of 90 individuals were investigated, comprising of 30
patients with ESRD on haemodialysis, 30 non-haemodialysing CRF
and 30 normal controls. Patients diagnosed to have CRF or ESRD
who were currently on haemodialysis and normal controls who
fulfilled the inclusion criteria were recruited into the
study. The individuals investigated were aged between 12 and
60 years, lacked clinical evidence of infection, disease or
drug use known to interfere with the immune system. Blood
samples were taken (before haemodialysis in cases of ESRD) and
the immunological parameters analyzed. A non-parametric data
analysis using SPSS computer package was done.
The results revealed aberrant counts of total lymphocytes,
CD4+ and CD8+ T-lymphocyte in both non-haemodialysing CRF and
ESRD patients on haemodialysis compared to the normal control.
These included low lymphocyte count with normal total WBC
count, low absolute CD4+ and CD8+ T-lymphocyte count. Serum
concentration of IgG, IgA and IgM were normal in the uraemic
patients compared to the control group. High CD4+ : CD8+ Tlymphocyte
ratio was observed in ESRD patients on
haemodialysis as compared to that in non-haemodialysing CRF.
It is concluded that non-haemodialysing CRF and ESRD on
haemodialysis have reduced lymphocyte count, absolute CD4+ and
CD8+ T-lymphocyte count. They both have normal concentration
of IgG, IgA and IgM compared to the control group. Higher
CD4+: CD8+ T-lymphocyte ratio is observed in ESRD patients on
haemodialysis.
Citation
Degree of Master of Medicine (Internal Medicine) in the University of NairobiPublisher
University of Nairobi Department of Medicine
Description
A dissertation submitted in partial fulfillment
for the Degree of Master of Medicine (Internal
Medicine) in the University of Nairobi