title: CD4+ lymphocyte adenosine triphosphate--a new marker in sepsis with acute kidney injury?
abstract: BACKGROUND
  AKI frequently develops in sepsis patients, significantly decreasing the overall prognosis. There are currently no diagnostic markers available which reliably predict the prognosis of sepsis-associated AKI. Recently, ATP content of CD4+ T cells (ATP_CD4) has been shown to correlate with survival in sepsis. The aim of the study was to determine ATP_CD4 in sepsis-associated AKI.
  
  
  METHODS
  Thirty-three patients with sepsis were prospectively analyzed for ATP_CD4 at three different time points. Results were related to survival, renal recovery, and further clinical/laboratory findings.
  
  
  RESULTS
  ATP_CD4 tended to lower in concentration at 48 h after onset of sepsis in those patients with complete renal recovery. There were no differences between patients with no AKI and those with AKI of different severity (AKIN 1-3). Urinary NGAL did not correlate with renal prognosis.
  
  
  CONCLUSIONS
  ATP_CD4 may serve as risk predictor in sepsis-associated AKI. Lower concentrations may indicate a higher chance of complete renal recovery in sepsis.
authors.affiliation: Department of Nephrology & Rheumatology, Georg-August-University Göttingen, Göttingen, Germany. d.patschan@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Patschan
authors.forename: Malte
authors.initials: M
authors.lastname: Heeg
authors.forename: Maria
authors.initials: M
authors.lastname: Brier
authors.forename: Gunnar
authors.initials: G
authors.lastname: Brandhorst
authors.forename: Simon
authors.initials: S
authors.lastname: Schneider
authors.forename: Gerhard A
authors.initials: GA
authors.lastname: Müller
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Koziolek
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000175:diagnosis*; D000209:Acute-Phase Proteins / Q000652:urine; D000255:Adenosine Triphosphate / Q000032:analysis*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes / Q000737:chemistry*; D018450:Disease Progression; D005260:Female; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine; D018805:Sepsis / Q000150:complications* / Q000175:diagnosis
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D000255:Adenosine Triphosphate