Circulating T lymphocyte subsets are associated clinical features and long-term prognosis in patients with hypertensive renal injury

Aim Although numerous studies have demonstrated the key role of immune system in hypertensive end organ damage, much less is known regarding the alterations of circulating immune cells in hypertensive renal injury.In this study, we examined the relationship between the distribution of T lymphocyte subsets and long-term clinical outcomes in patients with HRI. Methods In this study, a total of 431 patients (189 HRI patients and 242 hypertensions patients without renal injury) were recruited. Venous blood samples were used to detect for 15 distinct lymphocyte subsets by flow cytometry. T lymphocyte subsets and their correlations with clinical characteristics and long-term prognosis of patients were analyzed. Results A total of 431 patients (mean age 78.54 ± 14.23 years, 64.3% male) were enrolled. The median follow-up time was 16.54 months, range from 0.56 to 56.48 months. The overall mortality was 35.6% (144 cases). The age, gender, Scr (serum creatinine), level of urine protein, WBC (white blood cell) counts, levels of total lymphocytes, CD3 + CD8+, CD3 + HLADR+, CD3 + CD8 + CD28- and CD8 + CD95 + T cells were significantly higher in the HRI group compared to the non-HRI group (P < 0.05). Conversely, eGFR (estimated glomerular filtration rate) and CD3 + CD8 + CD28 + T cells were found to be lower in the HRI group (P < 0.05). As for the different CKD stages, patients with CKD "1 ~ 3" stages had higher levels of Hb, CD3+, CD3 + CD8+, CD3 + HLADR+, CD4 + CD69+, CD3 + CD8 + CD28-, CD4 + CD95 + and CD8 + CD95 + T cells than that of patients with "4 ~ 5" stages (P < 0.05). Multivariate COX regression analysis showed that age and CD3 + HLADR + T cells were independent risk factors for mortality [HR = 1.116(1.057,1.177), P < 0.001; HR = 8.676(1.887,39.886), P = 0.006]. However, CD3 + CD8 + and CD4 + CD25 + + CD127low T cells were independent protect factors for survive. [HR = 0.005(0.000,0.14), P = 0.002, HR = < 0.001(< 0.001,0.118), P = 0.03] Conclusions Patients with HRI showed lower levels of CD3+, CD3 + CD8+, CD3 + HLADR+, CD3 + CD8 + CD28- and CD8 + CD95 + T cells compared to non-HRI patients. Moreover, level of CD3 + HLADR + cells was independent risk factors for mortality in patients with HRI, while CD3 + CD8 + and CD4 + CD25 + + CD127low T cells were independent protect factors for survive. These results suggest that T lymphocyte differentiation and activation are associated with the progression and prognosis of HRI.