Abstract
Introduction: Serum procalcitonin (PCT) levels are known to be low in healthy individuals in healthy subjects but are increased in patients with a severe bacterial infection. It has not been extensively studied in children with chronic kidney disease (CKD). Patient and method: The present study was conducted on 60 chronic kidney disease pediatric patients. The patients were recruited from Beni-suef university hospital department of pediatrics. They were divided into 2 groups, group (I)(case) include 30 pediatric patients of chronic kidney disease with proven infection and the second group(II) (control) include 30 chronic kidney disease pediatric patients apparently healthy (without infections). Procalcitonin levels were measured by ELISA. Results: Children with proven infections had a significantly higher PCT (0.87±0.21ng/ml) than those without (0.50±0.18ng/ml), p = 0.04. The ideal cutoff value derived for serum PCT was 0.63ng/ml. This threshold value established a sensitivity of 93.3% and a specificity of 80.0%. Conclusion: This study indicates that significantly increased PCT concentration is a promising predictor of systemic bacterial infection in children with CKD, with good sensitivity and specificity. This study proposes that serum PCT is a convenient index of infection in CKD children at a cutoff value of 0.63ng/ml.
Highlights
Serum procalcitonin (PCT) levels are known to be low in healthy individuals in healthy subjects but are increased in patients with a severe bacterial infection
Children presented by fever over 38°C, with bacterial infection as bacterial pneumonia, urinary tract infection, vascular access infection, enterocolitis and meningitis . 4. control group that included 30 patients aged from 2 years to 13 years with chronic kidney disease but without suspicion of having infection
The present study included 60 of children suffering from chronic kidney disease 3 of them were diagnosed to have pneumonia, 25 of them were dignosed to have urinary tract infection, 2 of them were diagnosed to have enterocolitis, and 30 matched clinically have no signs or symptoms of infection and they were studied as control group
Summary
Serum procalcitonin (PCT) levels are known to be low in healthy individuals in healthy subjects but are increased in patients with a severe bacterial infection It has not been extensively studied in children with chronic kidney disease (CKD). Risk markers that possibly mark this susceptibility to infection are plentiful, including coexisting illnesses such as immunosuppressive therapy for the underlying kidney disease, uremia-induced leukocyte dysfunction, vaccine hypo-responsiveness, malnutrition, bloodstream infections fundamentally concerning vascular (fistula or catheters) access [4] and hemodialysis with frequent disturbance of the skin barrier For all these reasons, CKD may be considered as a condition of acquired immunodeficiency [5]. Infectious disease is a leading reason for intensive care unit (ICU) admittance and accounts for 15% to 25% of overall ICU admittance in CKD patients [7]
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