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Analytical Cellular Pathology
Volume 2019, Article ID 8389765, 11 pages
Research Article

Immunological Alterations due to Hemodialysis Might Interfere with Early Complications in Renal Transplantation

1Institute of Clinical Immunology, Medical Faculty, University of Leipzig, Leipzig, Germany
2Department of Internal Medicine, Neurology and Dermatology, Clinic for Endocrinology and Nephrology, Section of Nephrology, University Hospital Leipzig, Leipzig, Germany
3Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital Leipzig, Leipzig, Germany
4Institute of Immunology, University of Heidelberg, Heidelberg, Germany
5Center for Geriatric Medicine, Bezirksklinikum Regensburg, Regensburg, Germany
6Sigmund Freud PrivatUniversität, Wien, Österreich, Austria
7Medical Department I, Nephrology Division, University Hospital Ulm, Ulm, Germany
8Department of Nephrology, KfH Renal Unit, Hospital St. Georg, Leipzig, Germany
9Martin-Luther-University Halle/Wittenberg, Halle, Germany
10Institute for Organic Chemistry, University of Leipzig, Leipzig, Germany

Correspondence should be addressed to Ulrich Sack; ed.gizpiel-inu.nizidem@kcas.hcirlu and Franz Maximilian Rasche; ed.esylaid-hfk@ehcsar.znarf

Received 3 September 2018; Revised 4 January 2019; Accepted 18 February 2019; Published 25 March 2019

Academic Editor: Alain Chapel

Copyright © 2019 Kristin Mai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Chronic or intercurrent alterations of the immune system in patients with end-stage renal disease (CKD) and intermittent hemodialysis (CKD5D, HD) have been attributed to an acute rejection of renal allograft. Methods. Leukocyte subsets in flow cytometry, complement activation, and concentrations of TGFβ, sCD30 (ELISA), and interleukins (CBA) of fifteen patients eligible for renal transplantation were analyzed before, during, and after a regular HD. Results. Before HD, the median proportion of CD8+ effector cells, CD8+ CCR5+ effector cells, and HLA-DR+ regulatory T cells as well as the median concentration of soluble CD30 increased and naive CD8+ T cells decreased. During HD, there was a significant decrease in CD4- CD8- T cells () and an increase in CD25+ T cells (), sCD30 (), HLA-DR+ regulatory T cells (), and regulatory T cells (). TGFβ and sCD30 increased significantly over time. The activity of the classical complement pathway started to slightly increase after the first hour of HD and lasted until fifteen minutes after finishing dialysis. The decrease in the functional activity of the alternative pathway was only transient and was followed by a significant increase within 15 minutes after finishing the treatment. Conclusion. HD might interact with the allograft outcome by influencing T cell subsets and activation of the complement system in a biphasic course.