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World J Nephrol. Nov 6, 2014; 3(4): 268-276
Published online Nov 6, 2014. doi: 10.5527/wjn.v3.i4.268
T-cell ageing in end-stage renal disease patients: Assessment and clinical relevance
Ruud WJ Meijers, Michiel GH Betjes, Carla C Baan, Nicolle HR Litjens
Ruud WJ Meijers, Michiel GH Betjes, Carla C Baan, Nicolle HR Litjens, Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Centre, 3000 CA Rotterdam, The Netherlands
Author contributions: All authors contributed to this work.
Correspondence to: Ruud WJ Meijers, MSc, Department of Internal Medicine, Division of Nephrology and Transplantation, Erasmus Medical Centre, Room NA-523, PO Box 2040, 3000 CA Rotterdam, The Netherlands. r.meijers@erasmusmc.nl
Telephone: +31-10-7035421 Fax: +31-10-7044718
Received: June 10, 2014
Revised: July 8, 2014
Accepted: August 27, 2014
Published online: November 6, 2014
Processing time: 149 Days and 20.8 Hours
Core Tip

Core tip: The uremia-induced inflammatory environment in end-stage renal disease (ESRD) patients is associated with a prematurely aged T-cell compartment, resulting in defective T-cell-mediated immunity. ESRD patients are highly susceptible for infections, have an increased risk for virus-associated cancers, respond poorly to vaccination and have an increased risk for atherosclerotic diseases. Adequate renal replacement therapy in the form of kidney transplantation is able to diminish the uremic pro-inflammatory environment but unsuccessfully reverses the aged T-cell system. Assessment of T-cell ageing might be a tool to facilitate individualization of immunosuppressive regimes and prevent over-immunosuppression and its associated clinical complications in kidney transplant recipients.