Diagnostic accuracy of procalcitonin and presepsin for infectious disease in patients with acute kidney injury

Diagn Microbiol Infect Dis. 2016 Oct;86(2):205-10. doi: 10.1016/j.diagmicrobio.2016.07.015. Epub 2016 Jul 18.

Abstract

Procalcitonin (PCT) and presepsin (PSEP) are sepsis markers, but their diagnostic accuracy may be compromised in acute kidney injury (AKI). We evaluated their diagnostic accuracy in patients with/without AKI. This retrospective study comprised 91 patients with at least one criterion of systematic inflammatory response syndrome. AKI markers plasma neutrophil gelatinase-associated lipocalin (NGAL), plasma cystatin C (CysC), and estimated glomerular filtration rate (eGFR) were measured upon hospital admission and on days 1, 3, 5, and 7. Patients were divided into non-AKI and AKI groups. APACHE II severity scores were determined. PCT and PSEP levels were increased significantly in non-AKI and AKI patients with infection. NGAL, CysC, and eGFR in patients with infection were associated with PCT, PSEP, and APACHE II score, and levels of PCT and PSEP were correlated significantly with disease severity. PCT and PSEP are useful markers of bacterial infections in AKI but different thresholds should be applied.

Keywords: Acute kidney injury; Biomarker; Diagnosis; Infection; Presepsin; Procalcitonin.

MeSH terms

  • APACHE
  • Acute Kidney Injury / complications*
  • Aged
  • Biomarkers / blood*
  • Calcitonin / blood*
  • Female
  • Humans
  • Lipopolysaccharide Receptors / blood
  • Male
  • Peptide Fragments / blood
  • Retrospective Studies
  • Sepsis / complications*
  • Sepsis / diagnosis*
  • Sepsis / pathology

Substances

  • Biomarkers
  • Lipopolysaccharide Receptors
  • Peptide Fragments
  • presepsin protein, human
  • Calcitonin