Procalcitonin values after dialysis is closely related to type of dialysis membrane.
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.
Montagnana
Martina
M
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
Lippi
Giuseppe
G
Tessitore
Nicola
N
Salvagno
Gian Luca
GL
Danese
Elisa
E
Targher
Giovanni
G
Lupo
Antonio
A
Guidi
Gian Cesare
GC
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
C000606589:CALCA protein, human; D008567:Membranes, Artificial; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide