Renal failure and esterase-negative monocytes. 1997

D R Hull, and G M Markey, and T C Morris
Haematology Laboratory, Belfast City Hospital Trust, Northern Ireland.

Monocyte esterase deficiency (MED) has been found to be linked with autoimmune (1,2) and lymphoproliferative (2,3) disease. The incidence of MED where > 85% of peripheral blood monocytes are consistently negative in the cytochemical stain for monocyte esterase activity, was shown to be significantly raised in patients with renal failure (3.8%) as compared to the incidence in normal blood donors (0.8%) in a survey performed at the Belfast City Hospital in 1987 (2). The overall occurrence of any proportion of esterase-negative monocytes (ENMs) in patients with renal disease has not been previously studied. The aims of this study were to document this occurrence, and by examining the clinical and biochemical parameters associated with ENMs to identify possible reasons for their occurrence. The original survey data were reexamined and further information previously unreported regarding the occurrence of ENMs was extracted from the renal patient cohort data. Clinical and biochemical data were obtained from the hospital notes of the renal patients and associations sought between these parameters and the occurrence of ENMs. ENMs occurred in a significantly higher proportion (31%) of the renal patients than in the normal population (8%; p < 0.001 chi-sq.) or any other hospital population. A highly significant association between rising serum phosphate levels and increasing proportions of ENMs was identified (p < .001) and this association proved to be independent of serum creatinine levels and renal dialysis status. There is a marked increase in occurrence of esterase-negative monocytes in patients with renal failure. This increase was not caused by the degree of renal failure as reflected by serum creatinine levels, nor by renal transplantation or immunosuppressive therapy. A significant association between rising serum phosphate and increasing proportion of esterase-negative monocytes was identified. This new information, when considered with the previously described experimental and epidemiology evidence for malfunction of esterase negative monocytes, identifies a phenomenon which may contribute to the immunological difficulties of patients with chronic renal failure.

UI MeSH Term Description Entries
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D009000 Monocytes Large, phagocytic mononuclear leukocytes produced in the vertebrate BONE MARROW and released into the BLOOD; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. Monocyte
D010710 Phosphates Inorganic salts of phosphoric acid. Inorganic Phosphate,Phosphates, Inorganic,Inorganic Phosphates,Orthophosphate,Phosphate,Phosphate, Inorganic
D002118 Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Coagulation Factor IV,Factor IV,Blood Coagulation Factor IV,Calcium-40,Calcium 40,Factor IV, Coagulation
D003404 Creatinine Creatinine Sulfate Salt,Krebiozen,Salt, Creatinine Sulfate,Sulfate Salt, Creatinine
D004950 Esterases Any member of the class of enzymes that catalyze the cleavage of an ester bond and result in the addition of water to the resulting molecules. Esterase
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000469 Alkaline Phosphatase An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1.
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D017582 Renal Replacement Therapy Procedures which temporarily or permanently remedy insufficient cleansing of body fluids by the kidneys. Kidney Replacement Therapy,Replacement Therapy, Kidney,Replacement Therapy, Renal,Therapy, Kidney Replacement,Therapy, Renal Replacement,Kidney Replacement Therapies,Renal Replacement Therapies,Replacement Therapies, Kidney,Replacement Therapies, Renal,Therapies, Kidney Replacement,Therapies, Renal Replacement

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