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Kidney Week

Abstract: PO2458

The Utility of Procalcitonin in the Management of Kidney and Pancreas Transplant Recipients with Suspected Infection

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Gilligan, Sarah, University of Utah Health, Salt Lake City, Utah, United States
  • Shihab, Fuad S., University of Utah Health, Salt Lake City, Utah, United States
  • Raghavan, Divya, University of Utah Health, Salt Lake City, Utah, United States
  • Al-Rabadi, Laith, University of Utah Health, Salt Lake City, Utah, United States
  • Abraham, Josephine, University of Utah Health, Salt Lake City, Utah, United States
  • Hall, Isaac E., University of Utah Health, Salt Lake City, Utah, United States
Background

Procalcitonin is used to differentiate between bacterial and viral infections to guide judicious use of antibiotics. It has not, however, been well studied in renal and pancreas transplant recipients. These patients are frequently exposed to antibiotics and are at risk for developing resistant infections. Thus, there is a need for reliable markers of bacterial infection. The purpose of this study was to compare procalcitonin levels in patients with and without bacterial infection to determine whether procalcitonin is a reliable marker of bacterial infection in the transplant population.

Methods

Serum procalcitonin levels were measured on admission on all patients admitted to the Transplant Nephrology service with suspected infection as determined clinically by the on-call physician. We obtained all study data via chart review.

Results

Procalcitonin was measured in 154 patients. Demographics are included in the table. Forty-two patients (27%) had a positive bacterial culture. Mean procalcitonin for those with positive cultures was 5.36 ng/ml vs. 3.35 ng/ml in those without positive cultures, however this was not statistically significant (t=0.642, p=0.522). Patients with positive cultures were more likely to have procalcitonin levels >0.5 mg/ml (p=0.003). Procalcitonin had a modest but significant correlation with WBC count (r=0.249, p=0.002). Receiver operating characteristic analysis demonstrated an area under the curve (AUC) of 0.679 (95% confidence interval: 0.590-0.768, p=0.001) for predicting positive cultures with procalcitonin compared with an AUC of 0.584 (95% confidence interval: 0.474-0.694, p=0.110) for WBC count.

Conclusion

In this cohort of hospitalized kidney and pancreas transplant recipients, serum procalcitonin concentration was associated with bacterial infection and was found to be a better predictor than WBC count. More information is needed to determine the utility of procalcitonin measurements in clinical decision making in this patient population.