Abstract: Ｏｂｊｅｃｔｉｖｅ：This study aimed to elucidate the transcriptomic features and immune status of peripheral blood mononuclear cells （PBMC） in maintenance hemodialysis （MHD） patients using single-cell RNA sequencing （scRNA-seq） technology.
Ｍｅｔｈｏｄｏｌｏｇｙ：We conducted a study using scRNA-seq technology to analyze single nuclear cells in the peripheral blood of MHD-treated patients， revealing their status and molecular characteristics in relevant diseases. Unsupervised clustering and annotation analysis were employed to classify and identify individual PBMCs， followed by differential gene enrichment and intercellular communication analysis of major cell types. Furthermore， validation was performed through analysis of metabolomic datasets and clinical laboratory indicators.
Ｒｅｓｕｌｔｓ：We successfully established a transcriptomic atlas of PBMCs from MHD patients， identifying eight major cell types. Differential gene functional enrichment analysis between MHD patients and healthy controls revealed a significant increase in inflammation-related pathway enrichment scores in lymphocytes and monocytes. Meanwhile， B lymphocytes showed a decrease in lipid metabolism pathway enrichment scores， while monocytes exhibited an increasing trend in lipid pathway enrichment scores. Cell communication analysis indicated that T cells and monocytes play roles as both senders and receivers in multiple signaling pathways. Additionally， metabolomic analysis demonstrated an increase in lipid metabolism products in the peripheral blood of MHD patients. Clinical laboratory results further validated the presence of higher inflammation and lipid levels in these patients.
Ｃｏｎｃｌｕｓｉｏｎ：Single-cell RNA sequencing technology reveals long-term immune dysregulation， chronic inflammation， and disrupted lipid metabolism in the peripheral circulation of maintenance hemodialysis patients.

Key words: single-cell RNA sequencing, maintenance hemodialysis, mononuclear cells, lipid metabolism