title: [Infection in lupus nephritis: risk factors and significance of immune cell functional assay].
abstract: OBJECTIVE
  To explore the risk factors for infection in lupus nephritis (LN) and identify the correlation of ImmuKnow adenosine triphosphate (ATP) value with the development of infections.
  
  
  METHODS
  We respectively followed up 96 patients from January 2006 to December 2012 and all infectious episodes were recorded. The amount of ATP produced by CD4(+)T cells was measured by ImmuKnow assay and compared with the results of 27 healthy controls. Multivariate Logistic regression analysis was used to evaluate possible risk factors associated with infection in LN patients.
  
  
  RESULTS
  Among them, the incidence of infection was 22.68%. The mean CD4(+)T cell ATP level was significantly lower in LN patients with infection (258 ± 112) mg/L compared to both healthy controls (521 ± 257) mg/L (P < 0.01) and LN patients without infection (437 ± 193) mg/L (P < 0.05). A cutoff CD4(+)T cell ATP value of 300 mg/L predicted infection in LN patients with a specificity of 77% and a sensitivity of 77%. Multivariate Logistic analysis revealed that lower CD4(+)T cell ATP level (<300 mg/L), higher prednisone dosage ( ≥ 20 mg/d) and hyperglycemia (>10 mmol/L) were the independent predictors of infection. And the corresponding OR values were 3.47(P < 0.01), 1.17(P = 0.03) and 1.33 (P = 0.02) respectively.
  
  
  CONCLUSIONS
  ImmuKnow assay may be effective in identifying the elevated risk of infection in LN patients. And larger studies are required to establish the clinical advantages of this assay in LN treatment.
authors.affiliation: Department of Nephrology, Affiliated First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Lijie
authors.initials: L
authors.lastname: Tang
authors.forename: Jinfang
authors.initials: J
authors.lastname: Bao
authors.forename: Jing
authors.initials: J
authors.lastname: Hao
authors.forename: Yan
authors.initials: Y
authors.lastname: Dai
authors.forename: Qing
authors.initials: Q
authors.lastname: Yu
authors.affiliation: Email: ywj4169@163.com.
authors.forename: Weijie
authors.initials: W
authors.lastname: Yuan
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D016022:Case-Control Studies; D003141:Communicable Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology*; D008181:Lupus Nephritis / Q000150:complications* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015166:Monitoring, Immunologic; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000255:Adenosine Triphosphate