Diagnostic value of serum procalcitonin in detection of bacterial infections in chronic kidney failure patients on hemodialysis

Abstract

Bacterial infections are common causes of mortality and morbidity among CRF patients under hemodialysis that affects their prognosis. The prompt diagnosis and treatment would result in lower burden of disease. Objective: Accordingly in this study, the diagnostic value of serum procalcitonin for diagnosis of bacterial infections in patients with CRF under hemodialysis was assessed. Material and Methods: In this cross-sectional comparative study, 47 patients with CRF under hemodialysis in Sina and Imam-Reza Hospitals in Tabriz were evaluated and serum procalcitonin and CRP levels were compared between those with and without positive cultures and sensitivity and specificity were determined by ROC test. Results: Before-dialysis procalcitonin had no significant association with positive culturing infection and AUC was 0.561 and the sensitivity and specificity with cut-of point of 1.1 was 63.2% and 56%, respectively. After-dialysis procalcitonin had no significant association with positive culturing infection and AUC was 0.646 and the sensitivity and specificity with cut-of point of 1 was 73.7% and 56%, respectively. Before-dialysis CRP had no significant association with positive culturing infection and AUC was 0.595 and the sensitivity and specificity with cut-of point of 66 was 60% and 59.3%, respectively. After-dialysis CRP had significant association with positive culturing infection (P=0.032) and AUC was 0.684 and the sensitivity and specificity with cut-of point of 66 was 80.0% and 70.4%, respectively. In comparison with SIRS the sensitivity and specificity were 73.7% and 72% for before phase and 66% and 63.2% for after phase for PCT and 60% and 73.7% for CRP before and after phases. The AUC was 72.5%, 76.4%, 65.9%, and 75.9% with significance levels of 0.011, 0.003, 0.074, and 0.004, respectively.