Antigen phenotype and cytotoxic activity of natural killer cells in hemodialysis patients.

The antigen phenotype and cytotoxic activity of peripheral blood natural killer (NK) cells have been studied in 35 patients on hemodialysis, evaluating the influence exerted by different types of dialysis membranes and diverse clinical and biologic features of end-stage renal disease. Two-color immunofluorescent analyses with different monoclonal antibodies and flow cytometry were performed to identify the NK cells. Functional cytotoxic assays were simultaneously performed in the same patients. The results show that hemodialysis elicits higher proportions of CD3-/CD56+ and CD3-/CD16+ NK cells and a decrease in their cytotoxic activity compared with the control group. This alteration is related to the use of cuprophan membranes; biocompatible membranes would not significantly affect NK cells. The cuprophan membranes were also found to induce a higher degree of NK cell activation, measured as the number of CD16+/HLA-DR+ cells. Age appeared to be associated with NK cell function. Regarding age, in patients older than 65 years the change from cuprophan to biocompatible membranes was associated with a recovery of NK cytotoxic activity to normal levels. In summary, hemodialysis with cuprophan membranes induces an increased proportion of both NK cells and activated NK cells associated with decreased NK cytolytic activity.