Abstract
One hundred and twenty patients undergoing chronic hemodialysis were examined for immune competence using various immunological parameters. The numbers of white blood cells, lymphocytes and monocytes in peripheral blood decreased with the length of hemodialysis. Concerning the subsets of lymphocytes, the ratio of OKT8 to OKT4 was relatively low in patients whose histories were more than 5 years. The positivity of the SU-PS skin reaction test (delayed hypersensitivity) was greatly improved by hemodialysis. However, this decreased with the duration of hemodialysis. PPD or PHA skin reactions showed no marked changes with the length of hemodialysis. On the other hand, serum immunosuppressive acidic protein (IAP) was improved after the induction of hemodialysis, but increased with the duration of hemodialysis. Examination of these two markers in chronic hemodialysis patients suggested that the induction of hemodialysis improved some immune mechanisms. Serum carcinoembryonic antigen (CEA) was significantly increased in patients whose histories were more than 10 years. As mentioned above, the results of SU-PS skin reaction test and examination of serum IAP suggested that the immune competence of hemodialysis patients decreases with the length of hemodialysis. Furthermore, the OKT4/LKT8 ratio and serum CEA also indicated that patients whose histories were more than 10 years were considered to be low in immune competence and shold be checked for malignancies and the recurrence of tuberculosis.
