Telomere Attrition and Elongation after Chronic Dialysis Initiation in Patients with End-Stage Renal Disease

• <b><i>Aims:</i></b> To analyze changes in telomere length (TL) after dialysis initiation. <b><i>Methods:</i></b> In 59 Japanese incident dialysis patients, associations between TL in peripheral blood leukocytes, inflammatory biomarkers and nutritional status at baseline and changes in TL during 1 year of dialysis, were investigated. <b><i>Results:</i></b> Whereas relative TL decreased by 8.6% (median 14.4%), TL elongation occurred in 16 patients (27%). Change in TL (&#x0394;TL), defined as TL at 1 year minus TL at baseline, was associated with baseline TL (&#x03C1; = -0.70, p < 0.0001) and leukocyte count (&#x03C1; = 0.26, p = 0.044). In a logistic regression model, baseline TL (p < 0.0001) and leukocyte count (p = 0.047) were associated with &#x0394;TL. <b><i>Conclusions:</i></b> TL shortening was observed in most incident dialysis patients. In 16 of the 59 patients, TL elongation occurred, possibly reflecting a more robust biological aging in patients whose naïve leukocytes may have undergone less proliferation to replace lost leukocytes.

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