Immunophenotypic Characterization of Citrate-Containing A Concentrates in Maintenance Hemodialysis: A Pre-Post Study

Table 3

Changes in leucocyte and T-cell phenotypes after switching to citrate-acidified A concentrates.

Phenotypes (10^9/L)	Treatment (mean ± SD)		Linear mixed model
			Main effect: treatment
	Acetate	Citrate	Estimate (β)	value
Leucocyte^b	7.1 ± 2.0	7.2 ± 2.0	−0.13	0.43
Lymphocyte	5.2 ± 1.7	5.5 ± 1.4	−0.33	0.037
CD3+	2.6 ± 1.3	2.6 ± 1.2	0.03	0.84
CD3+CD4+	1.8 ± 1.0	1.7 ± 0.9	−0.05	0.70
CD3+CD8+	0.6 ± 0.4	0.6 ± 0.5	0.0007	0.99
CD3+CD4+/CD3+CD8+	4.4 ± 4.4	4.5 ± 4.3	−0.076	0.66
CD3+CD4+CD69+	0.04 ± 0.1	0.02 ± 0.01	−0.02	0.02
CD3+CD8+CD69+	0.05 ± 0.07	0.04 ± 0.04	−0.01	0.12
CD3+CD4+CD28+	1.7 ± 1.0	1.7 ± 0.9	0.04	0.74
CD3+CD8+CD28+	0.3 ± 0.2	0.3 ± 0.2	−0.005	0.76
CD3+CD4+PD1+	0.6 ± 0.3	0.6 ± 0.3	−0.04	0.29
CD3+CD8+PD1+	0.2 ± 0.2	0.2 ± 0.2	−0.001	0.93
CD3+CD4+TIM3+	0.03 ± 0.02	0.03 ± 0.02	<0.001	0.99
CD3+CD8+TIM3+	0.007 ± 0.005	0.006 ± 0.005	0.0009	0.21

A linear mixed model was built to analyze the parameters before and after switching to citrate-acidified A concentrates (with treatment as the main effect: citrate = 1, acetate = 0). To test for robustness of our results and to rule out confounding as far as possible, another model was built and adjusted for: HD-membranes used during acetate versus citrate, vascular access type, HD vs. HD (F), and session duration (see supplementary Table 5). Similar results as depicted above were obtained for treatment (citrate = 1).  < 0.05 was considered significant.