Korean J Intern Med.  2015 Mar;30(2):198-204. 10.3904/kjim.2015.30.2.198.

Cutoff value of serum procalcitonin as a diagnostic biomarker of infection in end-stage renal disease patients

• Lee WS
• Kang DW
• Back JH
• Kim HL
• Chung JH
• Shin BC

• KMID: 2160684
• DOI: http://doi.org/10.3904/kjim.2015.30.2.198

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.

Keyword

Cut-off value; Kidney failure, chronic; Infection; Procalcitonin

MeSH Terms

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
Biomarkers
Calcitonin
Inflammation Mediators
Protein Precursors