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Serum procalcitonin predicts development of acute kidney injury in patients with suspected infection

  • Xin Nie , Bin Wu , Yong He , Xunbei Huang , Zhongqiu Dai , Qiang Miao , Haolan Song , Tongxing Luo , Baoxiu Gao , Lanlan Wang EMAIL logo and Guixing Li EMAIL logo
Published/Copyright: March 18, 2013
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 51 Issue 8

Abstract

Background: Procalcitonin (PCT) is an early, sensitive, and accurate marker for diagnosing infection and sepsis. As sepsis and septic shock are dominant causes of acute kidney injury (AKI), we investigated whether PCT is an early predictor of AKI in patients with symptoms of infection.

Methods: Between January 2011 and October 2011, 1361 inpatients in West China Hospital who displayed infection symptoms were enrolled in our study. Levels of PCT, serum amyloid A (SAA), C-reactive protein (CRP), interleukin-6 (IL-6), and white blood cell count (WBC) were determined and participants’ renal function was monitored for 3 consecutive days.

Results: The rate of AKI occurrence 3 days after enrollment was 14.6%. Higher PCT levels were correlated with higher AKI occurrence rates and higher levels of serum urea, creatinine, and cystatin C (p<0.05). The area under the receiver-operating characteristic (ROC) curve (AUC) for PCT was 0.823, making it more predictive (p<0.0001) than SAA, CRP, IL-6, or WBC. The cut-off value of 1.575 ng/mL for PCT had the highest validity for predicting AKI in patients with infection symptoms. The sensitivity, specificity, negative-predictive value (NPV), positive-predictive value (PPV), negative-likelihood ratio (LR-), and positive-likelihood ratio (LR+) for this cut-off value were 61.7%, 84.6%, 93.6%, 37.5%, 0.415, and 4.98, respectively.

Conclusions: PCT can be used as a predictive marker for sepsis-induced acute kidney injury in patients with symptoms of infection.

Keywords: acute kidney injury; procalcitonin; receiver-operating characteristic curve
Corresponding authors: Guixing Li, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, P.R. China, Phone/Fax: +86 028 85422615; and Lanlan Wang, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, P.R. China, Phone/Fax: +86 028 85422752

Our study was funded by science and technology funds of Sichuan Province (grant number 2010SZ0252).

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article. Research funding played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

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Received: 2012-11-28
Accepted: 2013-02-18
Published Online: 2013-03-18
Published in Print: 2013-08-01

©2013 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/cclm-2012-0822
Keywords for this article
acute kidney injury; procalcitonin; receiver-operating characteristic curve

Articles in the same Issue

  1. Letters to the Editors
  2. Clinical utility of serum tumor markers and cytokines in cervical cancer and neoplasia
  3. Establishing reference intervals for LDL subfractions in a Korean population using the Lipoprint LDL system
  4. Measurement imprecision of common urinary biochemical analytes on the Roche Cobas 6000 system
  5. A comparison between turbidimetric inhibition immunoassay and capillary electrophoresis in glycated hemoglobin (HbA1c) measurement
  6. Commutability: a peculiar property of calibration and control materials. Definition and evaluation
  7. Diagnostic sensitivity of a panel of tests to detect monoclonal protein in Korean multiple myeloma patients
  8. Commutability of proficiency testing (PT): status of the matrix-related bias in general clinical chemistry
  9. Masthead
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  11. Editorial
  12. Why specifications for allowable glucose meter errors should include 100% of the data
  13. Reviews
  14. ABO blood group: old dogma, new perspectives
  15. Trace elements and bone health
  16. Mini Review
  17. The role of transcription factors in laboratory medicine
  18. Opinion Papers
  19. Nobelitis: a common disease among Nobel laureates?
  20. The syndrome of the “obsessive-compulsory scientist”: a new mental disorder?
  21. Can current analytical quality performance of UK clinical laboratories support evidence-based guidelines for diabetes and ischaemic heart disease? – A pilot study and a proposal
  22. Guidelines and Recommendations
  23. Survey of national guidelines, education and training on phlebotomy in 28 European countries: an original report by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PA)
  24. General Clinical Chemistry and Laboratory Medicine
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  26. Problems in determining thalassemia carrier status in a program for prevention and control of severe thalassemia syndromes: a lesson from Thailand
  27. An enzyme linked immunosorbent assay (ELISA) for the determination of the human haptoglobin phenotype
  28. Blood loss from laboratory diagnostic tests in children
  29. Hematocrit correction does not improve glucose monitor accuracy in the assessment of neonatal hypoglycemia
  30. Evaluation of a mobile clinical pathology laboratory developed for the home care of pediatric patients following transplantation of peripheral blood precursor cells
  31. Folic acid supplementation does not reduce intracellular homocysteine, and may disturb intracellular one-carbon metabolism
  32. Influence of spurious hemolysis on blood gas analysis
  33. Serum procalcitonin predicts development of acute kidney injury in patients with suspected infection
  34. Reference Values and Biological Variations
  35. Nationwide multicenter study aimed at the establishment of common reference intervals for standardized clinical laboratory tests in Japan
  36. Cancer Diagnostics
  37. Application of BRAF, NRAS, KRAS mutations as markers for the detection of papillary thyroid cancer from FNAB specimens by pyrosequencing analysis
  38. Comparative evaluation of the My5-FU™ immunoassay and LC-MS/MS in monitoring the 5-fluorouracil plasma levels in cancer patients
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