Circulating Immune Complexes in Regularly Dialyzed Patients with Chronic Renal Failure

Abstract

The prevalence of circulating immune complexes (CIC) was investigated using the Clq binding assay (Clq BA) and the conglutinin binding assay (Kg BA) in 200 patients undergoing maintenance hemodialysis. Increased C1 q binding was found in 45 % (87 of 194) of the patients, and the modified Kg BA gave elevated values in 31 % (20 of 65). The prevalence of CIC was similar in American and Swiss patients, and in patients undergoing hemodialysis, self-dialysis or peritoneal dialysis. In patients with ‘nonimmunologicaΓ renal diseases, CIC were detected with similar frequency. No change in CIC was noted during hemodialysis in 6 additional patients tested. The abnormality was not related to age, sex, duration of dialysis, hepatitis B antigenemia, bacterial infections, or transfusions. Anti-DNA antibodies were absent in all subjects tested and the results of the Clq BA were not changed by DNase digestion of eight sera with high Clq binding. Rheumatoid factor activity (RF) was detected in approximately one-fifth of the patients, and there was a direct correlation between positive Clq binding and RF. There was no correlation between CIC and lymphocytotoxic antibodies. This study demonstrated a high prevalence of CIC in dialyzed uremic patients and established its relationship to other immunological abnormalities.

Detection of Circulating Immune Complexes in Patients on Hemodialysis by a New Immunoassay

“…A recent study reported that the presence of C1C in regularly dialyzed patients was associated with prolonged graft survival in renal transplantation [1], We think that this new, sensitive im munoassay would be useful for detection of C1C, parti cularly intermediate C1C.…”

“…Until now, some researchers have reported that CIC were detected with a high incidence in patients on main tenance hemodialysis [1] and glomerulonephritis [2], by the method of the Raji cell radioimmunoassay [3], the radiolabeled Clq binding assay [4], or the microcomple ment consumption test [5]. These indirect assays are based on the immunochemical properties of immune complexes, and each has its special reactivity and sensi tivity.…”

Deterioration of Immune Complex Solubilization Activity of Serum by Increased Concentration of Factor D

“…Several studies have demonstrated the high preval ence of circulating IC in patients on maintenance hemo dialysis [18][19][20][21]. This might be partially due to the expo sure of these patients to several antigenic stimuli, includ ing infections, drugs, and agents that are formed in the circulation through the extracorporeal circuit.…”

“…Recent studies revealed that circulating IC are detected with a high incidence in patients on hemodialysis [18][19][20][21], and that the presence of 1C in dialyzed patients is associated with prolonged graft survival in renal transplantation [19].…”

Nephrogenic Systemic Fibrosis

“…About 30% of patients are positive for anticardiolipin antibodies [16, 17]. This raises the possibility of some abnormal antigenic stimulation or exposure to nuclear superantigens leading to this erratic inflammatory response seen in NSF, but then the patients who developed NSF have never been studied for the presence of the antigens or antiphospholipid antibodies.…”