title: Procalcitonin values after dialysis is closely related to type of dialysis membrane.
abstract: BACKGROUND
  Infections account for considerable morbidity and mortality in patients with chronic renal failure undergoing hemodialysis (HD). Diagnosis of infection in HD patients is challenging because the most used laboratory parameters may be increased even in the absence of infection. In this setting, procalcitonin (PCT) could be useful for detection of systemic bacterial infections.
  
  
  METHODS
  We measured high sensitivity C Reactive Protein (hsCRP) and PCT serum levels before and immediately after dialysis in 44 HD patients (22 treated with high- and 22 with low-flux membranes), without history of infections.
  
  
  RESULTS
  Patients on HD by high-flux membranes, but not by low-flux membranes, displayed mean PCT values significantly decreased after dialysis (high-flux: 0.50 vs. 0.26 ng/mL, p=0.005; low-flux: 0.41 vs. 0.42 ng/mL, p=0.863). HsCRP levels were unchanged. HsCRP correlated with PCT values both before and after HD only in patients on HD by low-flux membranes (r=0.51 and 0.47 before and after HD respectively; p<0.05).
  
  
  CONCLUSIONS
  Although PCT is considered a sensitive and specific diagnostic and prognostic marker of systemic bacterial infection, we suggest that specific reference ranges might be developed in patient with impaired renal function, also showing that and its clinical usefulness might be limited in patients undergoing HD with high-flux membranes.
authors.affiliation: Sezione di Chimica Clinica, Dipartimento di Scienze Morfologico-Biomediche, Ospedale Policlinico G.B. Rossi, Piazzale Scuro, 10, Verona 37134, Italy. martina.montagnana@med.lu.se
authors.forename: Martina
authors.initials: M
authors.lastname: Montagnana
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lippi
authors.forename: Nicola
authors.initials: N
authors.lastname: Tessitore
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Salvagno
authors.forename: Elisa
authors.initials: E
authors.lastname: Danese
authors.forename: Giovanni
authors.initials: G
authors.lastname: Targher
authors.forename: Antonio
authors.initials: A
authors.lastname: Lupo
authors.forename: Gian Cesare
authors.initials: GC
authors.lastname: Guidi
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D011498:Protein Precursors / Q000097:blood*; D006435:Renal Dialysis / Q000009:adverse effects*; D018709:Statistics, Nonparametric
chemical_list: C000606589:CALCA protein, human; D008567:Membranes, Artificial; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide