The natural elimination rate of procalcitonin in patients with normal and impaired renal function.
OBJECTIVE
Procalcitonin (PCT) plasma concentrations and its kinetic can be used as a diagnostic tool in critically ill patients and patients with sepsis. Since renal dysfunction is a frequent complication in these patients, and PCT is a protein with a low molecular weight, we have measured the half-life time of PCT after peak concentrations in patients with normal and impaired renal function. We also have analyzed the influence of patients age and gender on PCT elimination kinetics.


METHODS
Prospective clinical study. Renal dysfunction was assessed by plasma creatinine. The half-life time of PCT was evaluated 24 and 48 h after acute induction of PCT, when the focus of PCT induction has rapidly been eliminated.


METHODS
Intensive care unit of our University hospital, a tertiary health care institution.


METHODS
69 patients were included into the study.


METHODS
None.


RESULTS
The half-life-time of PCT was not significantly altered during renal dysfunction (26.1-33.1 h, 25-50 percentiles, creatinine clearance < 30 ml/min) when compared with normal renal function (22.3-28.9 h). It neither correlated with creatinine clearance (p=0.14), nor age (p=0.99) or gender (p=0.90, Pearson product-moment correlation).


CONCLUSIONS
The data of the present study demonstrate that assessment of PCT kinetic can also be used for diagnostic and prognostic reasons in patients with renal dysfunction. It may, however, exceed 24 h also in patients with normal renal function. As to the present knowledge, renal secretion does not contribute as a main pathway to PCT elimination.
Meisner
M
M
Department of Anaesthesiology, University of Erlangen-Nuremberg, Krankenhausstr. 12, D-91054 Erlangen. meisner@anae1.med.uni-jena.de
Schmidt
J
J
Hüttner
H
H
Tschaikowsky
K
K
D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D016638:Critical Illness; D005858:Germany; D006207:Half-Life; D006801:Humans; D007362:Intensive Care Units; D007677:Kidney Function Tests; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D051437:Renal Insufficiency / Q000097:blood* / Q000150:complications; D018805:Sepsis / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide