Procalcitonin and C-reactive protein plasma concentrations in nonseptic uremic patients undergoing hemodialysis.
OBJECTIVE
To assess procalcitonin (PCT) and C-reactive protein (CRP) plasma concentrations and clearance in nonseptic end-stage renal failure patients undergoing their first three hemodialysis sessions.


METHODS
Prospective observational consecutive clinical study at a university hospital.


METHODS
The study recruited 55 end-stage renal failure patients without evidence of systemic infection undergoing the creation of an arteriovenous fistula to start hemodialysis for the first time.


METHODS
Blood samples were collected before and after each of the first three (4-5 h) hemodialysis sessions. PCT was assayed by immunoluminometry.


RESULTS
The mean plasma concentration of PCT prior to the first three hemodialysis sessions declined significantly following each session. There was no significant difference between CRP plasma concentrations before and after hemodialysis sessions.


CONCLUSIONS
The presence of an elevated PCT in plasma of not yet dialyzed uremic nonseptic patients indicates that uremia per se and not the dialysis process is the origin of such elevation. PCT levels declined with successive hemodialysis sessions. We propose that in the not yet dialyzed uremic nonseptic patients a baseline PCT level of approx. 1.5 ng/ml should be expected. Although the mean plasma CRP level was elevated, hemodialysis had no significant effect on CRP concentration, making CRP a possible useful marker of sepsis in these patients.
Dahaba
Ashraf A
AA
Department of Anaesthesiology and Intensive Care Medicine, Karl Franzens University, Auenbruggerplatz 29, 8036, Graz, Austria. ashraf.dahaba@uni-graz.at
Rehak
Peter H
PH
List
Werner F
WF
D000368:Aged; D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000378:metabolism*; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D017582:Renal Replacement Therapy; D014511:Uremia / Q000097:blood* / Q000628:therapy
C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide