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A Study of Some Immunological Markers in Patients with Chronic Kidney Disease in Kerbala

Authors: Ali Mansoor Al-Ameri --- Hasanain salah jaafar2 --- Reyadh Hneawa2 --- Weaam Awad Al-Muhana*
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 2 Pages: 1878-1884
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Chronic kidney disease (CKD) is a progressive loss in renal functionover a period of months or years.Immune status of patients with CKD represents a fruitful area of research world-wide. Many hypotheses were mounted in this regards and most of them based on levels of certain immunological markers.Aim: To evaluate the serum levels of some immunologic markers in patients with CKD and to predict their correlation with the disease severity.Study design and objective: This is a cross sectional survey study. It was performed during December, 2013 through April, 2014at Al-Hussein Medical City, Holly Kerbala.Method: A total of 60 doctor-diagnosed patients with chronic kidney diseases for different causes and in variable stages of the disease. Their gender distribution and age range were (39 women; 30-62 years and 21 men; 33-70 years). Other 20 healthy persons were chosen as control group. An informed consent was taken from all the participants submitted to the study. Age, gender and presence of diabetes or hypertension were recorded. Then, 3-ml venous blood sample was taken from each participant and sera were isolated via centrifuge. The serum levels of the following markers were determined using ELISA; haptoglobin, alpha1 anti-trypsin, immunoglobulin-A (IgA), IgG, IgM, alpha-2-macroglobulin (A2M) and the complement proteins C3 and C4.Results: Serum levels of all studied immunologic markers were significantly lower in patients with CKD than those in the control subjects, p value < 0.05. An exclusion is the non significant rise in serum level of haptoglobin and alpha-2-macroglobulinnoticed in CKD stages other than ESRD.In addition, serum levels ofhaptoglobin, A2M, IgA and IgM are significantly lower in ESRD than other stages of CKD (p value < 0.05), while levels of C3 and C4 are significantly lower in moderate CKD than other stages of renal impairment included in this study (p value < 0.05).Discussion: It is well known that the CKD patients suffer significant immune compromization. Our data revealed down regulation of certain immunological parameters in their sera such as alpha1 anti-trypsin, immunoglobulin-A (IgA), IgG, IgM, and the complement proteins C3 and C4.This could explain the susceptibility to infection and abnormally delayed wound healing accompanying CKD.Conclusion: It was concluded that serum levels of all studied immunologic markers, excepthaptoglobin and alpha-2-macroglobulin,were significantly lower in patients with CKD than those in the healthysubjects. Furthermore, this is not associated with the presence or absence of diabetes and/or hypertension. This finding could, in part, prove that the immune deficiency status in these patients is purely due to their impaired renal functions. Key words: immunologic markers, chronic kidney disease.

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