Functional immune assay using interferon-gamma could predict infectious events in end-stage kidney disease

•Infections remain the second cause of death in end-stage kidney disease patients.•End Stage Kidney Disease patients are significantly immunocompromised.•Low IFN-γ levels in QuantiFERON-Monitor are associated with a ten-fold increased risk of infection.•QuantiFERON-Monitor could help to select patients who could benefit from therapeutic interventions to restore cellular immunity and to minimize both infections and rejections after kidney-transplantation. Infections remain the second most common cause of death in patients with end-stage kidney disease (ESKD). We aimed to evaluate non-specific cell-mediated immunity in an ESKD cohort using a functional assay applicable to routine use, QuantiFERON-Monitor (Qiagen), and assess whether it can predict infectious events. In this prospective study, we performed the QuantiFERON-Monitor test in 80 subjects including 54 patients with ESKD. QuantiFERON-Monitor is based on the measurement of plasma interferon-gamma (IFN-γ) after stimulation of NK-cells with a TLR-7 agonist, and T-cells with a TCR agonist. Patients were subsequently followed for 6 to 12 months. QuantiFERON-Monitor showed lower stimulated IFN-γ production in ESKD patients (n = 54) compared to healthy donors (n = 19) (p