Los of renal function is associated with uremia-associated immune deficiency, which contributes significantly to the mortality and morbidity of end-stage renal disease (ESRD) patients. In this review, the effect of ESRD on the adaptive cellular immune system is discussed. Progressive loss of renal function causes a preferential loss of number and function of lymphoid cells. More in depth analysis of these changes reveals a loss of thymic function, attrition of telomeres, and expanded memory T cell population, which is compatible with the concept of premature immunological ageing. Latency for cytomegalovirus is associated with more profound changes and the expansion of a unique pro-inflammatory, cytotoxic subset of CD4-positive CD28null T cells. Epigenetically, modifications in hematopoietic stem cells may underlie uremia-associated immunological ageing, which is not reversed by kidney transplantation. Possible therapeutic options to reverse or halt uremia-associated immunological ageing are discussed.

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Keywords Ageing, End-stage renal disease, Immune system, Inflammation, Oxidative stress, Uremia
Persistent URL dx.doi.org/10.1007/s11934-014-0471-9, hdl.handle.net/1765/86665
Journal Current Urology Reports
Betjes, M.G.H, & Litjens, N.H.R. (2015). Chronic kidney disease and premature ageing of the adaptive immune response. Current Urology Reports, 16(1), 1–7. doi:10.1007/s11934-014-0471-9