T-cell ageing in end-stage renal disease patients: Assessment and clinical relevance

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.