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Kidney Week

Abstract: PO0076

Is Procalcitonin a Reliable Marker of Bacterial Infection in Patients with AKI?

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Charkviani, Mariam, Amita Saint Francis Hospital, Evanston, Illinois, United States
  • Sohal, Sumit, Amita Saint Francis Hospital, Evanston, Illinois, United States
  • Murvelashvili, Natia, Amita Saint Francis Hospital, Evanston, Illinois, United States
  • Yanez Bello, Maria, Amita Saint Francis Hospital, Evanston, Illinois, United States
  • Trelles, Daniela, Amita Saint Francis Hospital, Evanston, Illinois, United States
  • Sharma, Alisha, Amita Saint Francis Hospital, Evanston, Illinois, United States
Background

Procalcitonin (PCT) is a biomarker that helps to distinguish bacterial infections from other causes of infection or inflammation and can be used as a helpful adjunct to clinical judgment for resolving diagnostic uncertainty. Limited data is available about the diagnostic value of PCT in patients with acute kidney injury (AKI). We aimed to assess the diagnostic usefulness of serum PCT level as a marker of bacterial infection in patients with AKI and assess the correlation of serum creatinine clearance to serum PCT level.

Methods

This retrospective case-control observational study involved patients admitted to the hospital during the study period and had PCT checked. Patients were categorized into proven, possible, and no bacterial infection groups. We compared PCT level in AKI group with proven bacterial infection vs no bacterial infection and PCT level during proven and no bacterial infection groups with AKI vs non-AKI. Patients with end-stage kidney disease and other causes of elevated PCT (pancreatitis, cancer, severe burns) were excluded.

Results

379 patients were analyzed, 24 patients were excluded from the study. 66 patients classified into the AKI group and 226 into the non-AKI group. 107 patients were in a proven bacterial infection group and 98 Patients in no bacterial infection group. The mean value of PCT was significantly higher with confirmed bacterial infection compared to no bacterial infection in all patients despite their renal function (4.9±8.75 vs 1.66±4.88, p<0.001). PCT level was higher in the AKI group than in the non-AKI group ( 10.99±12.24 vs 2.39±2.93, p>0.001) in patients with a proven bacterial infection. Patients with no infection had much higher PCT level in the AKI group as compared to the non-AKI group (5.76±14.67 vs 0.7±1.39, p=0.003). PCT level was also significantly higher during confirmed bacterial infection vs no bacterial infection in patients with AKI (9.2±11.05 vs 0.72±1.27, p=0.04). There was a weak positive correlation between creatinine clearance and PCT level (correlation coefficient 0.125, p=0.15).

Conclusion

Higher cutoff level of PCT is needed in patients with AKI to use it as a marker of infection. The specificity of PCT may decrease in patients in AKI if current reference cutoff values are used to guide clinical decisions.