ESRD, T-Cell Dysfunction
Conditions
Keywords
T cell dysfunction, end-stage renal disease, clinical outcome
Brief summary
Patients with end-stage renal disease (ESRD) suffer from high morbidity and mortality of cardiovascular and infectious disease and increased risk of all-cause mortality which is mainly attributed to the disturbed immune response. More and more evident indicated that T cell dysfunction was universal in ESRD. However, few studies clarified the association of T cell dysfunction and clinical outcomes. This study is aim to explore valuable markers of T cell dysfunction predicting bad clinical outcomes including death, cardiovascular disease, infection and tumor. Hopefully, these finding will provide foundation for further mechanism research and better therapeutic options for ESRD patients in the future.
Detailed description
Patients with end-stage renal disease (ESRD) suffer from high morbidity and mortality of cardiovascular and infectious disease and increased risk of all-cause mortality which is mainly attributed to the disturbed immune response. More and more evident indicated that T cell dysfunction was universal in ESRD. Recent evidence suggests uremia-related immune changes resemble to aging immune system, increasing immunological age of T cells by 20-30 years. As compared to an age-matched healthy control, ESRD patients present a lower thymic output of naïve T cells, a decline in the T-cell telomere length and an increase in the differentiation status towards the terminal differentiated memory phenotype with a large number of CD28-negative T cells. More importantly, these changes are strongly associated with a history of cardiovascular diseases and the occurrence of severe infectious episodes in this population, supporting the idea that T cell dysfunction is a critical feature in this population and will impact clinical outcomes profoundly. This study prospectively researched the predictive value of T cell dysfunction for all-cause mortality and clinical complication in hemodialysis (HD) patients.
Interventions
no specific interventions
Sponsors
Shanghai Zhongshan Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* had been on hemodialysis treatment for at least 6 months in Blood Purification Center,Zhongshan Hospital, Fudan University
Exclusion criteria
* underwent any kind of cardiovascular or infection event in three months * with hematological diseases, rheumatic diseases, active malignancies * with history of human immunodeficiency virus infection * currently use of any immunosuppressants * not followed-up at Zhongshan Hospital, Fudan University
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Death | January 2021 to December 2023 | mortality during the study |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cardiovascular disease | January 2021 to December 2023 | having documented congestive heart failure, coronary artery disease, peripheral arterial occlusive disease, or stroke |
| Infection event | January 2021 to December 2023 | having new onset of infections which requiring standard intravenous antibiotics or hospitalization |
| Cancer | January 2021 to December 2023 | having new discovered tumors |
Contacts
Primary ContactBo Shen, MD
Backup ContactFangfang Xiang, MD
Outcome results
None listed