{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:01:15Z","timestamp":1792036875024,"version":"4.4.0"},"reference-count":54,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research, Development, and Innovation Authority (RDIA)\u2014Kingdom of Saudi Arabia","award":["12982-iau-2023-TAU-R-3-1-HW-"],"award-info":[{"award-number":["12982-iau-2023-TAU-R-3-1-HW-"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: End-stage renal disease (ESRD) is a growing global health concern, and hemodialysis (HD) remains the most common life-sustaining therapy for patients with advanced kidney failure. Both humoral and cellular immunity are impaired post hemodialysis, leading to immune system dysfunction. Methods: We utilized flow cytometry to quantify cell populations based on surface markers, including CD3 (total T lymphocytes), CD4 (helper T-cells), CD8 (cytotoxic T-cells), CD19 (B lymphocytes), and CD16\/CD56 (natural killer (NK) cells). EDTA-blood samples were collected intravenously immediately before and after dialysis. Results: A consistent decline in CD3+ T lymphocytes was observed post hemodialysis. This reduction occurred across both male and female cohorts: p = 0.0342 and p = 0.0002, respectively. CD8+ cytotoxic T-cells decreased significantly post HD, p = 0.0003. Conversely, CD4+ helper T-cells exhibited a paradoxical increase, p = 0.0321. The divergent trends in CD4+ and CD8+ cells led to a statistically significant increase in the CD4\/CD8 ratio post dialysis, p = 0.0005. Notably, stratification by gender uncovered that the post-HD changes in CD4+ and CD8+ T-cells were exclusive to female patients. Females demonstrated a pronounced increase in CD4+ cells and a sharper decline in CD8+ cells compared to males. CD19+ B lymphocytes showed a statistically significant decline post hemodialysis (p &lt; 0.0001). While both genders exhibited reduced B-cell percentages, female patients experienced a more pronounced reduction than males. NK cells were severely depleted post dialysis in both male and female cohorts. Conclusions: Overall, the immune alterations observed in HD patients, including T-cell reduction, B-cell lymphopenia, and changes in NK cell populations, contribute to the increased risk of infections, malignancy, and cardiovascular disease in this population.<\/jats:p>","DOI":"10.3390\/jcm14186533","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T11:00:00Z","timestamp":1758106800000},"page":"6533","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Impact of Hemodialysis on Humoral and Cellular Immunity in Patients with Renal Failure"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7331-0624","authenticated-orcid":false,"given":"Renad M.","family":"Alhamawi","sequence":"first","affiliation":[{"name":"Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basmah Y.","family":"Shafea","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halah H.","family":"Bakhsh","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layal A.","family":"Fayraq","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samar T.","family":"Aloufi","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taraf F.","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah A.","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulaziz A.","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashar F.","family":"Alanize","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8944-0050","authenticated-orcid":false,"given":"Abdulaziz M.","family":"Bakhsh","sequence":"additional","affiliation":[{"name":"General and Specialized Surgery Department, College of Medicine, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4641-8248","authenticated-orcid":false,"given":"Emad S.","family":"Rajih","sequence":"additional","affiliation":[{"name":"General and Specialized Surgery Department, College of Medicine, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1395-9555","authenticated-orcid":false,"given":"Ibrahim A.","family":"Sandokji","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed H.","family":"Mahallawi","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Sciences Department, College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia"},{"name":"Health and Life Research Center, Taibah University, Madinah 42353, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Mahallawi, W.H., Ibrahim, N.A., and Mumena, W.A. 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