B-lymphocyte functions were studied in peripheral blood mononuclear cells of end-stage renal disease patients undergoing intermittent hemodialysis for longer than two years. T-cell-dependent B ...lymphocyte proliferation after pokeweed mitogen stimulation was low in half of the hemodialyzed patients. T cell-independent B cell response to Staphylococcus aureus, Cowan I, was also significantly reduced. Spontaneous production of immunoglobulin in cultures of peripheral blood mononuclear cells of uremic patients was comparable with that of healthy controls, but pokeweed mitogen-stimulated antibody secretion was significantly reduced with cells from patients undergoing hemodialysis. Helper T-cell functions in B-cell activation were also qualitatively deficient in uremic patients. It is concluded that B-cell activation and immunoregulation is defective in patients undergoing long-term hemodialysis.
Hemodialysis patients, nondialyzed azotemic patients and control subjects with chronic physical disabilities were tested on psychometric measures of attention, memory, and visuomotor speed and ...coordination. There was relatively little difference between the performance of dialysis patients and controls and no significant correlations were found between years of dialysis treatment and performance on any task. In contrast, nondialyzed azotemic patients were impaired on 9 of 14 tasks relative to controls and/or dialysis patients. Measured levels of blood urea nitrogen (BUN) and serum creatinine were significantly correlated with the performance of nondialyzed azotemic patients on several tasks. These results demonstrace a relationship between degree of renal failure and cognitive and perceptual-motor functioning. The mild impairments evident in dialysis patients do not seem to be directly attributable to dialysis treatments. Rather, the onset of hemodiaiysis appears to have beneficial effects on neuropsychological function.
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