Abstract
OBJECTIVE: To investigate the characteristics of T lymphocyte subsets and mitochondrial function in hemodialysis patients and to explore the effect of hemodialysis on these parameters. METHODS: Patients with end-stage renal disease (ESRD) from July 2023 to June 2024, who underwent mitochondrial function detection of T lymphocyte subsets, were included in this retrospective study. Patients were categorized into a hemodialysis group and a pre-dialysis group based on whether they received hemodialysis. The hemodialysis group was further divided into those with dialysis duration ≤ 12 months and those with > 12 months. Peripheral blood from ESRD patients was analyzed by flow cytometry to obtain data on T lymphocyte subsets, mitochondrial mass (MM), and low mitochondrial membrane potential (MMP-Low). Differences in T lymphocyte subsets mitochondrial parameters among distinct groups were analyzed, and the association between hemodialysis and the aforementioned mitochondrial parameters was investigated using multiple linear regression analysis. RESULTS: A total of 250 patients were enrolled (153 hemodialysis and 97 pre-dialysis). Compared with the pre-dialysis group, the hemodialysis group had significantly lower white blood cell count (5.62 ± 1.63 vs. 6.49 ± 1.93 × 10(3)/mm(3), p < 0.001) and neutrophil percentage (67.43 ± 8.10 vs. 70.73 ± 9.41%, p = 0.004), but a higher lymphocyte percentage (20.13 ± 6.39 vs. 17.73 ± 7.05%, p = 0.007). CD45+ lymphocyte percentage was also significantly higher in the hemodialysis group(20.13 ± 7.15 vs. 17.74 ± 7.28, p = 0.011), whereas the MM of CD3+, CD4+, and CD8+ T lymphocytes (2.66 ± 1.03 vs. 3.18 ± 1.45, p = 0.001; 2.96 ± 1.17 vs. 3.56 ± 1.53, p = 0.001; 2.28 ± 1.22 vs. 2.81 ± 1.64, p = 0.007, respectively), and the MMP-Low% of these T lymphocytes (21.86 ± 10.60 vs. 26.97 ± 11.76, p = 0.001; 15.53 ± 9.78 vs. 20.66 ± 10.42, p < 0.001; 31.12 ± 13.25 vs. 35.28 ± 15.17, p = 0.024, respectively), were significantly reduced. Among hemodialysis patients, those with dialysis duration > 12 months had significantly lower CD4+ T lymphocytes (455.66 ± 232.80 vs. 375.06 ± 150.99, p = 0.029) and MMP-Low% of CD3+ (25.17 ± 14.08 vs. 20.25 ± 8.02, p = 0.025), CD4+ (18.30 ± 13.47 vs. 14.18 ± 7.06, p = 0.046), and CD8+ (35.22 ± 16.09 vs. 29.13 ± 11.19, p = 0.019) T lymphocytes than those with ≤ 12 months. Linear regression analysis, after adjusting for multiple covariates, confirmed a significant association between hemodialysis and reduced mitochondrial parameters: decreased MM of CD3+ (0.699), CD4+ (0.735) and CD8+ (0.846) T lymphocytes, and reduced MMP-Low% of CD3+ (4.374%) and CD4+ (4.630%) T lymphocytes. CONCLUSION: T lymphocyte MM and MMP-Low% differ significantly between hemodialysis and pre-dialysis ESRD patients, and hemodialysis patients exhibit more pronounced T lymphocyte mitochondrial dysfunction.