Cutoff value of serum procalcitonin as a diagnostic biomarker of infection in end-stage renal disease patients.
10.3904/kjim.2015.30.2.198
- Author:
Wan Soo LEE
1
;
Dae Woong KANG
;
Jong Hun BACK
;
Hyun Lee KIM
;
Jong Hoon CHUNG
;
Byung Chul SHIN
Author Information
1. Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea. bcshin@chosun.ac.kr
- Publication Type:Original Article ; Clinical Study
- Keywords:
Cut-off value;
Kidney failure, chronic;
Infection;
Procalcitonin
- MeSH:
Adult;
Aged;
Area Under Curve;
Bacterial Infections/*blood/complications/*diagnosis/microbiology;
Biomarkers/blood;
Calcitonin/*blood;
Case-Control Studies;
Female;
Humans;
Inflammation Mediators/*blood;
Kidney Failure, Chronic/*complications/diagnosis/therapy;
Male;
Middle Aged;
Peritoneal Dialysis;
Predictive Value of Tests;
Protein Precursors/*blood;
ROC Curve;
Renal Dialysis;
Reproducibility of Results;
Up-Regulation
- From:The Korean Journal of Internal Medicine
2015;30(2):198-204
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Serum procalcitonin (PCT) levels are low in healthy individuals but are elevated in patients with a serious bacterial infection or sepsis. In this study, we examined the ability of serum PCT concentration to diagnose infections in end-stage renal disease (ESRD) patients, and sought to determine an appropriate threshold level. METHODS: Serum PCT levels were measured in ESRD patients on antibiotic therapy for a suspected bacterial infection (ESRD infection [iESRD] group, n = 21), and compared with those of ESRD patients on hemodialysis with no sign of infection (ESRD control [cESRD] group, n = 20). RESULTS: The mean serum PCT concentration of the iESRD group was significantly higher than in the cESRD group (2.95 +/- 3.67 ng/mL vs. 0.50 +/- 0.49 ng/mL, p = 0.006), but serum PCT concentrations did not correlate with severity of infection. The optimized threshold level derived for serum PCT was 0.75 ng/mL, rather than the currently used 0.5 ng/mL; this threshold demonstrated a sensitivity and specificity of 76.2% and 80.0% for infection and 100% and 60.6% for systemic inflammatory response syndrome, respectively, compared with the cutoff of 0.5 ng/mL. CONCLUSIONS: This study suggests that serum PCT at a cutoff value of 0.75 ng/mL is an appropriate indicator of infection in ESRD patients.
