title: 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.affiliation: Division of Pharmacy, Keiyu Hospital, Yokohama, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Kusano
authors.affiliation: Department of Clinical Pharmacology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Kato
authors.affiliation: Division of Nephrology, Keiyu Hospital, Yokohama, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Matsuda
authors.affiliation: Division of Nephrology, Keiyu Hospital, Yokohama, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hara
authors.affiliation: Division of Nephrology, Keiyu Hospital, Yokohama, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Fujii
authors.affiliation: Division of Pharmacy, Keiyu Hospital, Yokohama, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Division of Pharmacy, Keiyu Hospital, Yokohama, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Sekiyama
authors.affiliation: Division of Pharmacy, Keiyu Hospital, Yokohama, Japan.
authors.forename: Eiki
authors.initials: E
authors.lastname: Ando
authors.affiliation: Department of Clinical Pharmacology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugiyama
authors.affiliation: Department of Clinical Pharmacology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Hirano
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007239:Infections / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D012306:Risk; D012307:Risk Factors; D014511:Uremia / Q000378:metabolism
chemical_list: D015415:Biomarkers; D000255:Adenosine Triphosphate
keywords: ATP monitoring; Chronic kidney disease; Dialysis; Infection control; Lymphocyte