B lymphocytes subpopulations are associated with cardiac remodeling in elderly patients with advanced chronic kidney disease

Abstract

Aim: Chronic Kidney Disease (CKD) is independently associated with increased cardiovascular disease (CVD) risk. The aim of this study was to investigate the potential roles of B lymphocyte populations with cardiac remodeling in elderly patients with advanced CKD.

Methods: We designed a retrospective study in a cohort of 167 patients (84 advanced CKD patients with stage 4-5 and 83 non-CKD controls). B cell subsets: CD19(+)CD5(+) and CD19(+)CD5(-) B cells were identified by flow cytometry. Correlation of B cells subsets with cardiac remodeling and clinical data in elderly CKD patients were analyzed.

Results: In this study, we found that the prevalence of hypertension was more common in CKD patients than in the control subjects (P < 0.05). Spearman's analysis showed that CD19(+)CD5(+) B cells were negatively correlated with high sensitivity C-reactive protein (hsCRP), β2-microglobulin (β2-MG), serum creatinine (SCr), pro-brain natriuretic peptide (pro-BNP), high-sensitivity troponin T (TNT-hs), left ventricle end-diastolic dimension (LVDD), left ventricle end-systolic dimension (LVSD) and left ventricular mass (LVM), and CD19(+)CD5(-) B cells were negatively correlated with β2-MG, SCr, pro-BNP and TNT-hs (P < 0.05). In contrary, left ventricular ejection fractions (LVEF) was positively correlated with CD19(+)CD5(+) and CD19(+)CD5(-) B cells (P < 0.05). In addition, patients with higher levels of CD19(+)CD5(+) B cells exhibited lower level of pro-BNP, TNT-hs, interventricular septum (IVS), LVSD and LVM (P < 0.05). Higher levels of CD19(+)CD5(-) B cells also presented lower levels of pro-BNP, TNT-hs and LVSD, but higher levels of LVEF (P < 0.05). Cox regression analysis showed that patients with higher levels of LVSD, lower CD19(+)CD5(+)and CD19(+)CD5(-) B cells counts have a higher risk of all-cause mortality (P < 0.05).

Conclusions: Our results showed that CD19(+)CD5(+) and CD19(+)CD5(-) B lymphocytes were negatively correlated with ventricular hypertrophy-related echocardiographic parameters in advanced CKD patients, which indicated that B lymphocytes might be involved in pathogenesis and improve cardiac remodeling in CKD patients.

Keywords: B cells; Cardiac remodeling; Chronic kidney disease; Elderly.