Lower absolute numbers of CD4 ⁺ naïve and CD8 ⁺ effector memory cells in peripheral blood are potential predictive indicators of renal endpoint events in patients with chronic kidney disease

Background: There is no consensus on the distribution of T cell subsets during chronic kidney disease (CKD) progression. In this study, we aimed to investigate the levels of circulating T cell subsets in the peripheral blood of patients with CKD at various stages and the relationship between T cell parameters and renal endpoint events. Method: We selected 130 patients with non-dialysis stages I-V CKD and 75 healthy controls from Dongyang People's Hospital between February 2021 and March 2023. Multicolor flow cytometry was used to detect T cell subsets in patients at different stages of CKD. Result: The absolute CD4+ and CD8+ naïve T (TN)/central memory T (TCM), CD8+ effector memory T (TEM), and CD8+ terminally differentiated effector memory T cell counts in patients with stage V CKD were significantly lower than those in healthy controls. Compared with patients with early-stage CKD, those with advanced CKD stages had altered T cell expression patterns. The incidence of renal events during the follow-up period was 34.62%. CD4+TN cell counts ≥ 157/µL and CD8+TEM cell counts ≥ 59/µL were independent protective factors for adverse renal outcomes. Conclusion: Our results showed that a decrease in CD4+TN and CD8+TEM cell counts in the peripheral blood was closely associated with the occurrence of renal adverse events in patients with CKD and may be a potential new prognostic indicator.