| [ Summary ] |
It is well known that peripheral total lymphocyte counts and the tuberculin skin test are very useful in assessing nutritional status in most patients. However, the usefulness of the tuberculin skin test seems limited in dialysis patients, since the normal immune response is defective with uremia. A recent cohort study demonstrated that total lymphocyte count is an indicator of mortality in hemodialysis patients. Circulating acute-phase reactive proteins, C-reactive protein (CRP), interleukin-6 and tumor necrosis factor-α, have recently been shown tobe sensitive and useful markers for nutritional status in dialysis subjects. Blood CRP is especially negatively correlated with laboratory parameters, such as albumin. Leptin, an appetite suppressor secreted by adipose tissue, may also contribute to the development of malnutrition in dialysis patients. Further studies will be needed to explore the role of these immune parameters on short and long term malnutrition in relation to uremia. |