Mononuclear Cell Adenosine Deaminase in Patients with Chronic Renal Failure

Infections are considered as an important complication of uremia. The cause of immunosuppression in patients with renal failure is not exactly localized. Defect in the mononuclear cells with disturbance related to adenosine metabolism was presumed to be an important contributor to immune dysfunction in patients with renal failure. The study was carried out on 30 patients with chronic renal failure on regular hemodialysis (HD) (group 1), 30 patients with chronic renal impairment in predialysis periods (group 2), and 30 healthy control subjects (group 3). The complete medical history of all the patients, with respect to clinical examination, echocardiography, and nerve conduction studies was obtained. The mononuclear cell adenosine (MCAD) level, and mononuclear cell adenosine deaminase (MCADA) activity were measured. The MCAD level was higher in group 1 than in group 2, and was significantly higher in both groups than in the control group. However, the MCADA activity was found to be significantly lower in group 1 than in group 2, and was considerably lower in both groups when compared with the control group. The MCAD was found to be positively correlated to the history of infection and negatively correlated to the ejection fraction in groups 1 and 2. There was a positive correlation between MCAD and the presence of neuropathy in group 1, but not in group 2. The MCADA activity was found to be low in patients with chronic renal failure, which further decreased with HD. This condition may lead to high level of MCAD, which is related to the development of infection, neuropathy, and myocardial depression in those patients.