Effect of different hemodialytic schemes on mitochondrial parameters of T cell subsets in patients with end-stage renal disease

Objective  To explore the changes of mitochondrial parameters of T lymphocyte subsets in patients with end-stage renal disease （ESRD） before and after treatment under two different hemodialytic schemes.

Methods  From September 2021 to February 2022, 100 ESRD patients undergoing regular dialysis were selected as study subjects. They were randomized into two groups of control and observation （n = 50 each）. Absolute count and percentage of T lymphocytes （CD3⁺, CD4⁺, CD8⁺）, CD4⁺/CD8⁺ ratio, mitochondrial mass （MM） and mitochondrial damage index （MDI） were observed before and after 6-month treatment.

Results  No significant inter-group difference existed in T count/percentage of lymphocyte subgroup, MM or MDI pre-treatment （P＞0.05）. In observation group, CD4⁺% （39.71 ± 12.96）% vs （33.53 ± 7.13）%, P＜0.05 and CD4⁺/CD8⁺ （2.27 ± 0.63） vs （1.39 ± 0.56）, P＜0.05 decreased while CD3⁺MDI （72.43 vs 118.21, P＜0.05）, CD4⁺MDI （123.70 vs 332.21, P＜0.05） and （180.74 vs 312.33, P＜0.05） increased after treatment. In control group, CD4⁺%（28.56 ± 6.28）% vs （33.53 ± 7.13）%, P＜0.05; CD4⁺/CD8⁺（1.25 ± 0.53） vs （1.39 ± 0.56）, P＜0.05, absolute count of CD3⁺ （538.99 ± 254.18） vs （556.37 ± 275.78）, P＜0.05 and CD3⁺MM rose （143391.84 ± 37879.02） vs （145307.76 ± 35485.05）, P＜0.05 while CD3⁺MDI （137.29 vs 118.21, P＜0.05）, CD4⁺MDI （397.67 vs 332.21, P＜0.05） and CD8⁺MDI declined （335.63 vs 312.33, P＜0.05. In observation group, CD3⁺ count （685.60 ± 271.32） vs （895.67 ± 351.42）, P＜0.05, CD4⁺ count （295.53 ± 198.60） vs （585.67 ± 261.86）, P＜0.05, CD3⁺% （51.43 ± 12.15）% vs （58.25 ± 14.99）%, P＜0.05, CD4⁺% （30.53 ± 12.41）% vs （39.71 ± 12.96）%, P＜0.05, CD4⁺/CD8⁺ （1.57 ± 0.60） vs （2.27 ± 0.63）, P＜0.05, CD3⁺MM （147886.07 ± 55841.38） vs （152638.22 ± 49675.75）, P＜0.05, CD4⁺MM （163490.80 ± 64714.31） vs （165679.79 ± 68484.85）, P＜0.05 and CD8⁺MM spiked （125774.47 ± 46354.09） vs （129638.64 ± 42896.53）, P＜0.05 while CD3⁺MDI （139.75 vs 72.43, P＜0.05）, CD4⁺MDI （203.73 vs 123.70, P＜0.05） and CD8⁺MDI dropped （267.33 vs 180.74, P＜0.05）.

Conclusion  Both hemodialysis and hemodialysis plus hemoperfusion may reduce oxidative damage of cells and improve immune function of ESRD patients to some extent. As compared with hemodialysis, hemodialysis plus hemoperfusion offers a better efficacy.