Background: End-stage renal disease (ESRD) patients treated with renal replacement therapy (RRT) have premature immunologically aged T cells which may underlie uremia-associated immune dysfunction. The aim of this study was to investigate whether uremia was able to induce premature ageing of the T cell compartment. For this purpose, we examined the degree of premature immunological T cell ageing by examining the T cell differentiation status, thymic output via T cell receptor excision circle (TREC) content and proliferative history via relative telomere length in ESRD patients not on RRT.Results: Compared to healthy controls, these patients already had a lower TREC content and an increased T cell differentiation accompanied by shorter telomeres. RRT was able to enhance CD8 + T cell differentiation and to reduce CD8 + T cell telomere length in young dialysis patients. An increased differentiation status of memory CD4 + T cells was also noted in young dialysis patients.Conclusion: Based on these results we can conclude that uremia already causes premature immunological ageing of the T cell system and RRT further increases immunological ageing of the CD8 + T cell compartment in particular in young ESRD patients.

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Keywords Ageing, CD28null, End-stage renal disease, Renal replacement therapy, T lymphocytes, Uremia
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Journal Immunity and Ageing
Meijers, R.W.J, Litjens, N.H.R, de Wit, E.A, Langerak, A.W, van der Spek, A, Baan, C.C, … Betjes, M.G.H. (2012). Uremia causes premature ageing of the T cell compartment in end-stage renal disease patients. Immunity and Ageing, 9. doi:10.1186/1742-4933-9-19