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Abstract: TH-PO261

Natural Killer Cell Activity Contributes to Development of Sarcopenia in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Park, Hyeong cheon, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Jung eun, Yongin Severance Hospital, Yongin-si, Korea (the Republic of)
  • Park, Hae Yeul, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
  • Jung, Kwon soo, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
  • Lee, Moon hyoung, Gangnam Severance Hospital, Seoul, Korea (the Republic of)
  • Choi, Hoon Young, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
Background

Sarcopenia, a syndrome of reduced skeletal muscle mass and function, is associated with decrease immune system responsiveness. Decreased natural killer (NK) cell activities have been suggested in hemodialysis (HD) patients. The aim of this study is to determine the relationship between NK cell activity and sarcopenia in HD patients.

Methods

We enrolled 116 clinically stable HD patients (62 male) and clinical data such as age, sex, height, weight, dialysis duration, and comorbidities were collected. Biochemical parameters, including white blood count, hemoglobin, albumin, C-reactive protein, and iron profiles were determined before the dialysis session. Muscle mass was evaluated by bioimpedance analysis (Inbody S10, Biospace Co., Korea) and hand grip strength was assessed using digital hand grip dynamometer. The diagnosis of sarcopenia was made according to the guidelines of Asian Working Group for Sarcopenia. Cytotoxic activity of NK cells was determined using commercial blood test assay (NK Vue, ATGen, Seongnam, Korea) that uses serum of ex vivo stimulated whole blood to detect interferon (IFN)-γ secreted from NK cells as an indicator of NK cell activity. IFN-γ levels were further quantitated by ELISA. Univariate and multivariate binominal logistic regression analyses were used to determine the association between clinical variables including NK cell activity and sarcopenia in HD patients.

Results

A total of 29 patients (25%) were diagnosed as sarcopenia among 116 HD patients. The sarcopenic HD patients were significantly older (70.1 ± 8.1 vs. 61.1 ± 11.3 years, P<0.001) and had longer HD vintage (63.1 ± 54.0 vs. 38.5 ± 38.9 months, P=0.029), whereas showed lower body mass index (BMI) (20.7 ± 3.8 vs. 23.4 ± 6.2 kg/m2, P<0.01), lower appendicular lean muscle mass (ALM, 8.26 ± 2.8 vs. 9.83 ± 4.5 kg/m2, P<0.01), and lower activity of NK cell (392 ± 517 vs. 876 ± 667 pg/mL, P=0.001). Low NK cell activity had a very significant correlation with sarcopenia, and the statistical significance was maintained even after adjustment for age, sex, BMI, ALM in multivariate regression analysis [Exp(B) 0.104(0.033, 0.324), P<0.001].

Conclusion

Our results show that the NK cell activity of sarcopenic HD patients is significantly decreased and such low NK cell activity may contribute to development of sarcopenia in HD patients.