Immunophenotypic Characterization of Citrate-Containing A Concentrates in Maintenance Hemodialysis: A Pre-Post Study

Introduction. Due to chronic inflammation, maintenance hemodialysis (MHD) patients continue show excess mortality. Acetate-free citrate-buffered A concentrates could be a way improve the biocompatibility of procedure, reduce and thus in long term prognosis patients. Methods. Using pre-post design (3 months acetate followed by 3 citrate-acidified standard bicarbonate-based dialysate hemodialysis, CiaHD) linear mixed model analysis 61 stable HD patients, we assessed impact CiaHD on counts phenotypes peripheral T cells monocytes flow cytometry. Results. Switching left C-reactive protein (CRP) levels leucocyte unaffected. However, increased lymphocyte ex vivo. Furthermore, found decrease total CD3+CD4+CD69+ ((109/L), mean ± SD: acetate, 0.04 1.0 versus citrate, 0.02 0.01; P = 0.02) activated cells, while number CD28+ remained stable. No differences were noted regarding T-cell exhaustion marker expression, CD14+CD16+ monocyte counts, PMN-MDSCs. Conclusion. Compared with has minor CD4+T-cell activation, which was independent systemic CRP ionized magnesium, calcium levels, other dialysis prescription modalities.