Evaluation of the Infection Risk in Dialysis and Chronic Kidney Disease Patients Using an ATP Monitoring Assay.

Abstract

The ATP monitoring assay is a useful biomarker for risk monitoring to detect infection and rejection episodes in transplant recipients. Hemodialysis patients have a higher rate of infectious mortality. Infections in hemodialysis patients are mainly caused by venous catheters, uremia, malnutrition and inflammation. However, the risk of infection episodes has not been evaluated using a lymphocyte ATP monitoring assay in hemodialysis and chronic kidney disease (CKD) patients. We measured the ATP amounts in the peripheral CD4+ cells of CKD (N = 85) and dialysis patients (N = 17) using an "Immuknow" assay kit. These CKD patients were divided, according to kidney disease stage, into G3a, G3b, G4, and G5 groups. The ATP amounts in CD4+ cells of the dialysis patients and each of the CKD groups were compared with healthy subjects. In both the dialysis and CKD patients, the ATP amounts in CD4+ cells were lower than in healthy subjects. Furthermore, there were significant differences in the ATP amounts between healthy subjects and each of the CKD-G3a, CKD-G3b, and CKD-G4 groups (P < 0.05). Patients with CKD-G3a, CKD-G3b and CKD-G4 were evaluated as being at high risk for infection according to the lymphocyte ATP monitoring assay. However, the ATP amounts in the dialysis and CKD-G5 patients did not differ from those in healthy subjects to a statistically significant extent. These results suggest that the ATP amount in the CD4+ cells of these patients with serve renal failure are influenced by dialysis treatment, uremia and/or oxidative stress.

• Authors: Junichi Kusano, Rei Kato, Hiroto Matsuda, Yoshikazu Hara, Yoshiaki Fujii, Shinya Suzuki, Masao Sekiyama, Eiki Ando, Kentaro Sugiyama, Toshihiko Hirano
• Journal: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy (Ther Apher Dial) Vol. 21 Issue 3 Pg. 270-278 (Jun 2017) ISSN: 1744-9987 [Electronic] Australia
• PMID: 28296195 (Publication Type: Journal Article)
• Copyright: © 2017 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

Chemical References

• Biomarkers
• Adenosine Triphosphate

Topics

• Adenosine Triphosphate (metabolism)
• Adult
• Aged
• Aged, 80 and over
• Biomarkers (metabolism)
• CD4-Positive T-Lymphocytes (metabolism)
• Case-Control Studies
• Female
• Humans
• Infections (epidemiology, etiology)
• Male
• Middle Aged
• Oxidative Stress
• Renal Dialysis
• Renal Insufficiency, Chronic (therapy)
• Risk
• Risk Factors
• Uremia (metabolism)