Peritonitis Incidence is Correlated with Increased Leptin and CD4/CD8 Ratio in Peritoneal Dialysis Patients

Peritonitis is one of the leading cause of hospitalization in peritoneal dialysis patients. Although inflammatory markers show an increased inflammatory response, cellular immune response is decreased in ESRD patients. Uremia has many affects on leptin and T lymphocytes that are basic elements of the cellular immune system. In this study, we aimed to demonstrate the relationship between peritonitis and the CD4, CD8 positive lymphocyte count and ratio, and serum leptin level in peritoneal dialysis patients. Forty-six ESRD patients who had been receiving peritoneal dialysis therapy for at least 12 months were enrolled to the study. Serum leptin level, WBC count, and the CD4 and CD8 T lymphocyte count and ratio were measured. A healthy control group was also enrolled to the study . The measured mean serum leptin level of the patient group was statistically significantly higher than the control group (1697.673±1586.081 and 478.057±601.654). The calculated peritonitis incidence was 0.49 peritonitis/year. The number of peritonitis attacks significantly correlated with the duration of peritoneal dialysis, BMI, CD4:CD8 ratio, ESR and serum leptin level. In conclusion, although the ESRD patients have increased leptin and CD4 percentage of T lymphocytes, their immune system is not healthy to combat infections satisfactorily due to possible multifactorial reasons such as increased inflammation and decreased lymphocyte count.