Potential use of procalcitonin as biomarker for bacterial sepsis in patients with or without acute kidney injury

Nakamura, Yoshihiko; Murai, Akira; Mizunuma, Mariko; Ohta, Daisuke; Kawano, Yasumasa; Matsumoto, Norihiko; Nishida, Takeshi; Ishikura, Hiroyasu

doi:10.1016/j.jiac.2014.12.001

Cited by 43 publications

(27 citation statements)

References 24 publications

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“…We have no information on the focus of infection and pathogens detected. Second, the fact that PCT levels may be affected by either acute or chronic renal dysfunction is under debate [24,33] and the diagnostic accuracy of PCT level may be lower in patients with AKI or CKD. On the other hand, selection bias should be taken into account because of the exclusion criteria used.…”

Section: Discussionmentioning

confidence: 99%

Urinary [TIMP-2] × [IGFBP7] and serum procalcitonin to predict and assess the risk for short-term outcomes in septic and non-septic critically ill patients

Godi

Rosa

Martino

et al. 2020

Ann. Intensive Care

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Background: Biomarkers can play a critical role by facilitating diagnosis and stratification of disease, as well as assessment or prediction of disease severity. Urinary tissue inhibitor of metalloproteinase-2 and insulin-like growth factor binding protein 7 product ([TIMP-2] × [IGFBP7]) predict the development and progression of AKI and recently procalcitonin (PCT), a widely used biomarker for sepsis diagnosis and management, has been associated with AKI occurrence in ICU patients. To assess combinations of [TIMP-2] × [IGFBP7] and PCT results for prediction and risk stratification of short-term outcomes in septic and non-septic patients, a retrospective cohort analysis of critically ill patients was performed in a multidisciplinary ICU. ROC curve analysis was used in order to evaluate predictive performance of combined results of [TIMP-2] × [IGFBP7] and PCT at the time of admission for AKI development. To verify the utility of adding [TIMP-2] × [IGFBP7] and PCT results for risk assessment, we evaluated the predictive value of having a singlemarker positivity compared to a double-marker positivity using the widely used cutoff of 0.3 (ng/mL) 2 /1000 for [TIMP-2] × [IGFBP7] and 0.5 μg/L for PCT. Risk assessment for AKI occurrence within 48 h, acute kidney disease (AKD) and mortality at 7 days was performed by logistic/Cox regression analysis. Results: 433 patients were analysed, of whom 168 had AKI within 48 h (93 septic and 65 non-septic patients). Combination of [TIMP-2] × [IGFBP7] and PCT showed a good predictive ability for AKI occurrence (AUC 0.81, 95% CI 0.77-0.86, p < 0.001, Sens 78%, Spec 73%). Combinations of biomarkers increased the odd ratios (OR) considerably. A single-marker positivity showed a fourfold risk increase, while the double-marker positivity a 26-fold risk increase for AKI occurrence. Moreover, the double-marker positivity showed an elevated risk for AKD at 7 days in non-septic patients (OR 15.9, 95% CI 3,21-73,57, p < 0.001) and for mortality within 7 days in septic patients (HR 4.1, 95% CI 1.4-11.8, p = 0.001). Conclusions: Although combining the results of [TIMP-2] × [IGFBP7] and PCT may be a useful tool to identify and stratify ICU patients at high risk for septic AKI and short-term adverse outcomes, data should be confirmed in a large prospective study.

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Section: Discussionmentioning

confidence: 99%

Urinary [TIMP-2] × [IGFBP7] and serum procalcitonin to predict and assess the risk for short-term outcomes in septic and non-septic critically ill patients

Godi

Rosa

Martino

et al. 2020

Ann. Intensive Care

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“…It was reported that PCT worked well as a diagnostic biomarker in patients without acute kidney injuries, 18 while Urbonas et al 8 showed that PCT had additional diagnostic value for detecting bacteremia/sepsis in pediatric patients with febrile neutropenia. However, Aimoto et al 19 reported that neither PCT nor CRP levels were useful for determining the cause of a fever.…”

Section: T a B L E 3 Comparison Of The Biomarker Levels Between The Nmentioning

confidence: 99%

Diagnostic performance of procalcitonin, presepsin, and C‐reactive protein in patients with hematological malignancies

Ebihara

Kobayashi

Ishida

et al. 2017

Clinical Laboratory Analysis

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“…Moreover, PCT has also been shown act as a chemoattractant for monocytes at inflammation site and higher PCT level would recruit more monocytes and contribute to the inflammation-mediated cell injury (34). Apart from cytotoxicity and inflammation, increased PCT level has also been reported to be associated with increased creatinine and decreased glomerular filtration rate (35)(36)(37). And higher level of PCT was observed in AKI patients compared to non-AKI patients (38,39).…”

Section: Discussionmentioning

confidence: 99%

Association between procalcitonin and acute kidney injury in patients with septic shock: A case-control study

et al. 2020

Preprint

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Objective This study aims to assess the relationship between serum procalcitonin (PCT) and acute kidney injury (AKI) induced by sepsis shock.Methods A case-control study was designed which included patients that admitted in intensive care unit (ICU) between January 2015 and October 2018. The worst values of biochemical parameters in the first 48 hours from septic shock admission to ICU were evaluated. According to KDIGO guideline, these patients were divided into AKI and non-AKI groups.Results Of 1631 patients screened, 157 patients were included in the primary analysis in which 84 (53.5%) patients with AKI. Multiple logistic regression results showed that PCT (OR=1.017, 95% CI 1.009- 1.025, P<0.001) was associated with AKI induced by septic shock. The ROC analysis showed that the cutoff point for PCT to predict AKI development was 14 ng/ml, and with a sensitivity 63%, specificity 67%. Specifically, in multivariate piecewise linear regression, the occurrence of AKI decreased with the elevation of PCT when PCT was between 25mol/L and 120 mol/L (OR 0.963, 95% CI 0.929-0.999; P= 0.042). The AKI increased with the elevation of PCT when PCT was either less than 25mol/L (OR 1.077, 95% CI 1.022-1.136; P= 0.006) or more than 120mol/L (OR 1.042, 95% CI 1.009-1.076; P= 0.013). Moreover, the PCT level was significant higher in AKI group only in female patients with age under 75(P=0.001).Conclusions Our data revealed a nonlinear relationship between PCT in 48 hours admission to ICU and AKI in septic shock patients and PCT could be used as a biomarker of AKI only in female patients under 75 years with sepsis shock.

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Potential use of procalcitonin as biomarker for bacterial sepsis in patients with or without acute kidney injury

Cited by 43 publications

References 24 publications

Urinary [TIMP-2] × [IGFBP7] and serum procalcitonin to predict and assess the risk for short-term outcomes in septic and non-septic critically ill patients

Urinary [TIMP-2] × [IGFBP7] and serum procalcitonin to predict and assess the risk for short-term outcomes in septic and non-septic critically ill patients

Diagnostic performance of procalcitonin, presepsin, and C‐reactive protein in patients with hematological malignancies

Association between procalcitonin and acute kidney injury in patients with septic shock: A case-control study

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