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. Conclusion: ATP-CD4 may serve as risk predictor in sepsis-associated AKI. Lower concentrations may indicate a higher chance of complete renal recovery in sepsis.