Inflammatory and Humoral Immune Status in Chronic Kidney Disease

Background: Chronic kidney disease (CKD) is a present world health problem.It is widely accepted that uremia, depresses the immunity and make them most susceptible to infection.The relationship between uremia, impaired immune status, and susceptibility to infection has never been established. Aim:The study was designed to know the association between levels of immunoglobulins and inflammatory marker hs-CRP in various stages of CKD patients and comparing it with healthy controls.Materials and methods: One hundred twenty-one CKD patients staged based on eGFR were evaluated for serum Immunoglobulins (G, A&M), hs-CRP and compared between the different stages and also with healthy controls (n = 24).Results: Out of 121CKD patients (male = 88, female = 33) with a mean age of 46 ± 15 years, known cases of hypertension (HTN) were seen in 32%, both DM and HTN 38%, DM only in 1% and remaining were with no h/o DM or HTN.The median levels of blood urea, serum creatinine, and hs-CRP are significantly high across the CKD stages and when compared to healthy controls (p <0.0001).IgM levels showed significant (p = 0.0005) decrease across all the stages of CKD, whereas IgG levels have decreased trend across the stages but statistically not significant. Conclusion:Based on our findings it can be concluded that a deficiency of immunoglobulins was noticed in a considerable number of uremic patients from all stages of CKD, suggesting inhibition of their synthesis by the uremic state.Uremic patient is associated with a state of immune dysfunction characterized by immunodepression that leads to a high prevalence of infections, and also by immunoactivation causing inflammation (increase in hsCRP).