CIRCULATING HEMATOPOIETIC STEM AND PROGENITOR CELLS AND CLINICAL CHARACTERISTICS IN CHRONIC KIDNEY DISEASE

 

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CIRCULATING HEMATOPOIETIC STEM AND PROGENITOR CELLS AND CLINICAL CHARACTERISTICS IN CHRONIC KIDNEY DISEASE

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Kenichiro
Iio
Kenichiro Iio iioken16@outlook.com Osaka Minami Medical Center Nephrology Kawachinagano Japan *
Rei Iio reiiio.ra@gail.com Osaka Habikino Medical Center Nephrology Habikino Japan -
Risa Kishida kishida.risa.su@mail.hosp.go.jp Osaka Minami Medical Center Nephrology Kawachinagano Japan -
Yuuki Watanabe watanabe.yuuki.cd@mail.hosp.go.jp Osaka Minami Medical Center Nephrology Kawachinagano Japan -
Masashi Morita morita.masashi.sb@mail.hosp.go.jp Osaka Minami Medical Center Nephrology Kawachinagano Japan -
Hiroki Omori oomori.hiroki.mn@mail.hosp.go.jp Osaka Minami Medical Center Nephrology Kawachinagano Japan -
Yoshitaka Isaka isaka@kid.med.osaka-u.ac.jp Osaka University Nephrology Suita Jamaica -
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Circulating CD34-positive cells comprise hematopoietic stem and progenitor cells and reflect hematopoietic function and marrow reserve. Lower circulating CD34-positive cell counts have been linked to hematopoietic stem-cell aging and to higher risks of infection, cardiovascular events, and mortality. Chronic kidney disease (CKD) also increases mortality; however, the association between circulating CD34-positive cell counts and CKD has not been fully investigated. This study aimed to clarify the relationship between circulating CD34-positive cell count and clinical characteristics in CKD patients.

We enrolled 195 outpatients with CKD stages G3–G5 (median age, 76 years; 66.3% men). Patients with active infection, collagen disease, or acute kidney injury were excluded. Circulating CD34⁺CD45^dim cells were enumerated by flow cytometry. Multivariable linear regression was conducted to evaluate associations between circulating CD34-positive cell counts and clinical variables, including peripheral blood parameters (hematologic indices and T-cell subsets) and CKD-related clinical features.

The median circulating CD34-positive cell count was 0.68/μL. Lower CD34-positive cell counts were significantly associated with lower white blood cell counts (p<0.001), platelet counts (p<0.001), lymphocyte counts (p<0.001), and CD4⁺ T-cell counts (p<0.001). In addition, older age (p<0.001), lower eGFR (p=0.007), and higher intact parathyroid hormone levels (p=0.006) were associated with lower CD34-positive cell counts. Anemia showed no association with CD34-positive cell count.

In CKD patients, circulating CD34-positive cell counts were associated with hematologic indicators hematologic parameters and decreased kidney function. These findings suggest that renal dysfunction, in addition to aging, may contribute to diminished hematopoietic function and marrow reserve.

Kewords