How should procalcitonin and C‐reactive protein levels be interpreted in haemodialysis patients?

Demir, Nazlım Aktuğ; Sümer, Şua; Çelik, Gülperi; Afşar, Rengin Elsürer; Demir, Lütfi Saltuk; Ural, Onur

doi:10.1111/imj.13952

Cited by 12 publications

(16 citation statements)

References 21 publications

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“…Our analysis showed that higher values for NLR and PLR in high (> 3 mg/L) hs-CRP level group than those in low (≤ 3 mg/L) level group in non-dialysis ESRD patients, is consistent with the result in HD patients [11]. Similar to hs-CRP, PCT and ferritin are also inflammatory markers [8,9]. Thus, it is reasonable to have the result that high hs-CRP level group has significantly higher values of PCT and ferritin compared to low hs-CRP level group in our current study.…”

Section: Discussionsupporting

confidence: 86%

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Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in evaluation of inflammation in non-dialysis patients with end-stage renal disease (ESRD)

Xia

Liu

et al. 2020

BMC Nephrol

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Background Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been reported to be associated with inflammation in end-stage renal disease (ESRD) receiving dialysis. However, the value of NLR and PLR in non-dialysis patients with ESRD remains unclear. Methods Among 611 non-dialysis patients with ESRD in The First Affiliated Hospital of University of South China (2012–2018), we compared NLR and PLR in patients with high-sensitivity C-reactive protein (hs-CRP) levels of ≤3 mg/L vs. > 3 mg/L. Correlation of NLR and PLR to hs-CRP, PCT, ferritin were analyzed. Receiver operating characteristics (ROC) analysis was used for estimating sensitivity and specificity of NLR and PLR. Results NLR was higher in the patients with high hs-CRP levels (> 3 mg/L), compared to patients with low hs-CRP levels (≤ 3 mg/L) [5.74 (3.54–9.01) vs. 3.96 (2.86–5.85), p < 0.0001]. Additionally, PLR was higher in high hs-CRP group than in low group [175.28 (116.67–252.26) vs. 140.65 (110.51–235.17), p = 0.022]. In the current study, NLR and PLR were both positively correlated with hs-CRP (rs = 0.377, p = 0.000 for NLR; rs = 0.161, p = 0.001 for PLR), PCT, leukocytes, neutrophils, platelets, and age. NLR or PLR with a cut-off value of 5.07 or 163.80 indicated sensitivity and specificity were 65.67 and 66.37% (AUC = 0.69) or 57.21 and 57.52% (AUC = 0.55), respectively. Conclusions NLR or PLR was positively correlated with hs-CRP in non-dialysis patients with ESRD. NLR might be better for identifying inflammation than PLR in this population.

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Section: Discussionsupporting

confidence: 86%

“…Inflammatory markers such as C-reactive protein (CRP), procalcitonin (PCT), and ferritin are widely used in ESRD [8][9][10]. However, those traditional biomarkers have their limitations.…”

Section: Introductionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in evaluation of inflammation in non-dialysis patients with end-stage renal disease (ESRD)

Xia

Liu

et al. 2020

BMC Nephrol

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“…Currently, PCT level kinetics and CRP level kinetics have become the focus of research efforts for identification and assessment of disease prognosis. 9,10 Under normal physiological conditions, the levels of serum PCT and CRP are very low, and are maintained at a relative equilibrium in the body. When sepsis is caused by an inflammatory stimulus due to pathogen infection, the levels of serum PCT and CRP increase rapidly due to the host response to infection.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of PCT and CRP evaluation for adult ICU patients with sepsis and septic shock: retrospective analysis of 59 cases

et al. 2019

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Objective To investigate the prognostic significance of serum procalcitonin (PCT) and C-reactive protein (CRP) in patients with sepsis and those with septic shock. Methods Fifty-nine patients were divided into sepsis and septic shock groups, as well as survivor and non-survivor groups, according to the severity of the disease and patient survival. Serum PCT and CRP measurements at the time of hospitalization in the intensive care unit were examined. Results On the 2nd, 3rd, and 5th days, the CRP level was higher in the non-survivor group than in the survivor group, and the serum CRP level was higher in patients in the septic shock group than in patients in the sepsis group. Regarding changes in serum PCT level in each group, the levels of PCT were significantly different between non-survivor and survivor groups, whereas they did not differ between patients in the sepsis and septic shock groups. Serum PCT kinetics (ΔPCT) were similar between groups. Conclusions Serum PCT and CRP have good clinical diagnostic and prognostic value for patients with sepsis and septic shock. Kinetic studies of PCT and CRP can improve sensitivity and accuracy when evaluating the prognosis of patients with sepsis and those with septic shock.

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“…The levels of PCT, CRP and SAA have important clinical significance in the diagnosis and treatment of Sepsis and other infectious diseases. [5][6][7][8][9][10] Application value of PCT, hs-CRP and SAA detection SAA is one of the markers of inflammatory activity in the acute response phase, mainly produced by macrophages. 11 SAA has the characteristics of a low basal level and high induced expression, and it is produced in large quantities in the inflammatory acute response period.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the clinical application values of PCT, hs-CRP and SAA detection in the early diagnosis of sepsis

2020

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Objectives: To investigate the clinical application values of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP) and serum amyloid A (SAA) in the early diagnosis of sepsis. Methods: In this retrospective analysis, 36 patients admitted to Liaocheng People’s Hospital were selected from May 2018 to July 2019. According to infectious disease diagnostic criteria, 17 patients were confirmed to have sepsis (observation group), and 19 patients were determined to be nonseptic (control group). The levels of PCT, CRP and SAA of patients were detected on admission, and the clinical application values of PCT, CRP and SAA for sepsis were compared. Results: Seventeen patients were included in the observation group, including 9 males and 8 females, with an average age of 52.18 ± 9.49 years; 19 patients were included in the control group, including 12 males and 7 females, with an average age of 51.53 ± 8.50 years. On admission, there were significant differences in white blood cell (WBC) count (t = 5.134), neutrophil count (t = 3.143), lymphocyte count (t = 2.510), PCT (t = 9.250), hs-CRP (t = 2.947) and SAA (t = 11.360) between the observation group and the control group, and the differences were statistically significant. For the comparison of clinical application values: the sensitivity of PCT, hs-CRP and SAA was 78.95%, 52.17% and 50.00%, respectively; the specificity of PCT, hs-CRP and SAA was 88.24%, 61.54% and 37.50%, respectively; the area under the ROC curve (AUC) of PCT, hs-CRP and SAA was 0.920, 0.684 and 0.870, respectively; the logistic regression coefficient of PCT, hs-CRP and SAA was -0.577, -0.028 and -0.009, respectively; and the 95% confidence interval (CI) of PCT, hs-CRP and SAA was 0.779-0.985, 0.508-0.828 and 0.716-0.958, respectively. Conclusion: Compared with hs-CRP and SAA, PCT had a higher clinical application value for sepsis, and PCT could be used as a reliable index for the early diagnosis of sepsis. doi: https://doi.org/10.12669/pjms.36.7.2544 How to cite this:Sui Y, Xin W, Feng L. Comparison of the clinical application values of PCT, hs-CRP and SAA detection in the early diagnosis of sepsis. Pak J Med Sci. 2020;36(7):---------. doi: https://doi.org/10.12669/pjms.36.7.2544 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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How should procalcitonin and C‐reactive protein levels be interpreted in haemodialysis patients?

Abstract: We specified PCT and CRP cut-off values with high PPV and NPV for revealing the presence of bacterial infection and sepsis in HD patients.

Cited by 12 publications

References 21 publications

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in evaluation of inflammation in non-dialysis patients with end-stage renal disease (ESRD)

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in evaluation of inflammation in non-dialysis patients with end-stage renal disease (ESRD)

Prognostic significance of PCT and CRP evaluation for adult ICU patients with sepsis and septic shock: retrospective analysis of 59 cases

Comparison of the clinical application values of PCT, hs-CRP and SAA detection in the early diagnosis of sepsis

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