Abstract
It is unclear whether serum procalcitonin (PCT) levels rise in patients with acute kidney injury (AKI), and it is also unclear whether the elevation of PCT levels in this setting is independent of the existence of infection and impaired renal clearance. We conducted a retrospective study in a regional teaching hospital in Taiwan to evaluate the AKI-predictive ability of serum PCT among critically ill patients. We enrolled 330 patients (mean age, 70.5 ± 16.4 years; 57.0% men) who were admitted to the intensive care unit (ICU) from 1 July 2016, to 31 December 2016, and who had serum PCT measurement performed within 24 h after ICU admission. We used the generalized additive model and generalized linear model to evaluate the association of serum PCT levels and renal function variables. In addition, we used the multivariate logistic regression method to demonstrate serum PCT level as an independent predictor of AKI in both the non-infected patients (odds ratio (OR) = 1.38, 95% confidence interval (CI) = 1.12–1.71, p = 0.003) and the infected patients (OR = 1.23, 95% CI = 1.03–1.46, p = 0.020). In conclusion, serum PCT level at ICU admission is an independent predictor of developing AKI irrespective of infection among critically ill patients.
Highlights
Acute kidney injury (AKI) is a common but complex disorder characterized by a rapid deterioration of kidney function
This study aimed to prove the hypothesis that serum PCT level is an independent predictor of the development of AKI, and its predictive ability is independent of infection and impaired renal function among critically ill patients
The baseline serum creatinine (SCr) values of 46 patients were estimated by the Modification of Diet in Renal Disease (MDRD) formula due to insufficient data
Summary
Acute kidney injury (AKI) is a common but complex disorder characterized by a rapid deterioration of kidney function. AKI affects about 2 to 7% of hospitalized patients and 13 to 78% of critically ill patients [1,2,3,4], with high morbidity and mortality [5]. Advancements in therapies for AKI have been limited, and the prognoses in AKI patients remain unsatisfactory [6]. A crucial strategy for resolving this frustrating problem is to find promising biomarkers that could early identify the onset, location, type, etiology, and severity of kidney injury [7]. PCT has been proposed as a promising marker for microbial infection and sepsis [10], as well as a useful marker to guide antibiotics therapy in critical patients with severe sepsis and septic shock [11]
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