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Abstract: FR-PO774

Analysis of Infection Rate According to Natural Killer Cell Activity in Hemodialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kim, Seok-hyung, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Jung eun, Yongin Severance Hospital, Yongin-si, Korea (the Republic of)
  • Kim, Hyung Jong, Bundang CHA Medical Center, CHA University, Seongnam, GYEONGGI-DO, Korea (the Republic of)
  • Choi, Hoon Young, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Hyunwook, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Tae hoon, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Mirae, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Taeyeon, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Park, Hyeong cheon, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
Background

Natural killer (NK) cells are lymphocytes of innate immune system that play a key role in host defense against diverse range of pathogens. NK cell deficit has been suggested in patients undergoing hemodialysis (HD) with conflicting results regarding their activity and impaired antimicrobial activity in host defense. Aim of this study was to determine the susceptibility to bacterial infection according to NK cell cytotoxic activity in HD patients.

Methods

Clinically stable HD patients without active malignancy or immunosuppressive medications were enrolled (N=204). NK Vue™ assay (ATGen Co. Seoul, Korea), that uses serum of ex vivo stimulated whole blood to detect interferon (IFN)-γ secreted from NK cells, was used to assess NK cell activity. This NK cell activity was consecutively assessed at six-month intervals from 2015 to 2017. We further investigated the incidence of major infections requiring intravenous antibiotics or hospitalization according to NK cell activity during the study period.

Results

Mean patient age was 61.4 ± 13.8 years and 58.8% were male. During the study period, a total of 214 major infections occurred. Mean baseline NK cell activity was 586.2 ± 540.7 pg/mL. Decreases in NK cell activity were significantly correlated with incidence of major infections. Furthermore, mean changes in NK cell activity were significantly different between periods at which infections have occurred and those periods free of infections, -71.7 ± 875.7 pg/mL and 110.5 ± 846.0 pg/mL, respectively (P=0.016). In univariate logistic analysis, older age [odds ratio (OR): 1.018; 95% CI, 1.004-1.032, P=0.010], higher serum C-reactive protein (CRP) [OR: 1.052; 95% CI, 1.010-1.096, P=0.014] and decreased NK cell activity [OR: 0.975; 95% CI, 0.955-0.995, P=0.017] were associated with higher incidence of infection. After adjusting for age, sex and CRP, decreased NK cell activity was independently associated with higher incidence of infection. [OR: 0.976; 95% CI, 0.956-0.996, P=0.019] Increases in CRP was not significantly correlated with decreases in NK cell activity (R=-0.056, P=0.189).

Conclusion

Our results show higher incidence of infection during period of greater decrease in NK cell activity from baseline. NK cell activity could thus be a useful marker to predict risk of infection in HD patients.