End-stage renal disease (ESRD) causes premature ageing of the immune system. However, it is not known whether hemodialysis (HD) and peritoneal dialysis (PD) similarly affect the T cell system. The aim of our study was to analyse whether dialysis modality may mitigate ESRD-induced immune senescence. We explored a large population of patients (675 ESRD patients) and both confirmed and refined the results in a second cohort (84 patients). HD patients exhibited higher inflammatory monocytes counts (44/mm3 (1–520) vs 36/mm3 (1–161); p = 0.005). Patients on HD also had higher frequency of CD8 T cells (24% (7–61) vs 22% (8–42); p = 0.003) and reduced CD4/CD8 ratio. Such results were confirmed in the second cohort. Moreover, both CD4 + CD57 + CD28- (3.25% (0–38.2) vs 1.05% (0–28.5); p = 0.068) and CD8 + CD57 + CD28- (38.5% (3.6–76.8) vs 26.1 (2.1–46.9); p = 0.039) T cells frequencies were increased in HD patients. Telomere length did not differ according to dialysis modality, but was inversely related to ferritin levels (r = − 0.33; p = 0.003). There was a trend towards higher telomerase activity in PD patients (11 ± 13 vs 6 ± 11; p = 0.053). Thymic function was not different in PD and HD patients. Patients on PD before transplantation had a higher risk of acute rejection after kidney transplantation (HR, 1.61; 95%CI, 1.02 to 2.56; p = 0.041). More pronounced inflammation with hemodialysis may induce premature aging of the immune system. This observation correlates with a lower risk of acute kidney rejection in patients previously on HD. Clinical consequences in patients maintained on dialysis should be determined. Trial registration: NCT02843867 , registered July 8, 2016.

中文翻译：

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ESRD 相关免疫表型取决于透析方式和铁状态：临床意义

终末期肾病 (ESRD) 会导致免疫系统过早老化。然而，尚不清楚血液透析 (HD) 和腹膜透析 (PD) 是否同样影响 T 细胞系统。我们研究的目的是分析透析方式是否可以减轻 ESRD 诱导的免疫衰老。我们探索了大量患者（675 名 ESRD 患者），并在第二个队列（84 名患者）中确认和完善了结果。HD 患者表现出更高的炎性单核细胞计数（44/mm3 (1-520) vs 36/mm3 (1-161)；p = 0.005）。HD 患者的 CD8 T 细胞频率也更高（24% (7-61) vs 22% (8-42)；p = 0.003）并且 CD4/CD8 比率降低。这样的结果在第二个队列中得到证实。此外，CD4 + CD57 + CD28- (3.25% (0–38.2) vs 1.05% (0–28.5); p = 0.068) 和 CD8 + CD57 + CD28- (38.5% (3.6–76.8) vs 26.1 (2.1– 46.9); p = 0.039) HD 患者的 T 细胞频率增加。端粒长度不因透析方式而异，但与铁蛋白水平呈负相关（r = - 0.33；p = 0.003）。PD 患者有更高的端粒酶活性趋势（11 ± 13 对 6 ± 11；p = 0.053）。PD和HD患者的胸腺功能没有差异。移植前接受 PD 的患者在肾移植后发生急性排斥反应的风险较高（HR，1.61；95%CI，1.02 至 2.56；p = 0.041）。血液透析引起的更明显的炎症可能会导致免疫系统过早老化。这一观察结果与以前接受过 HD 的患者发生急性肾排斥反应的风险较低有关。应确定维持透析患者的临床后果。试用注册：