title: Serum procalcitonin predicts development of acute kidney injury in patients with suspected infection.
abstract: BACKGROUND
  Procalcitonin (PCT) is an early, sensitive, and accurate marker for diagnosing infection and sepsis. As sepsis and septic shock are dominant causes of acute kidney injury (AKI), we investigated whether PCT is an early predictor of AKI in patients with symptoms of infection.
  
  
  METHODS
  Between January 2011 and October 2011, 1361 inpatients in West China Hospital who displayed infection symptoms were enrolled in our study. Levels of PCT, serum amyloid A (SAA), C-reactive protein (CRP), interleukin-6 (IL-6), and white blood cell count (WBC) were determined and participants' renal function was monitored for 3 consecutive days.
  
  
  RESULTS
  The rate of AKI occurrence 3 days after enrollment was 14.6%. Higher PCT levels were correlated with higher AKI occurrence rates and higher levels of serum urea, creatinine, and cystatin C (p<0.05). The area under the receiver-operating characteristic (ROC) curve (AUC) for PCT was 0.823, making it more predictive (p<0.0001) than SAA, CRP, IL-6, or WBC. The cut-off value of 1.575 ng/mL for PCT had the highest validity for predicting AKI in patients with infection symptoms. The sensitivity, specificity, negative-predictive value (NPV), positive-predictive value (PPV), negative-likelihood ratio (LR-), and positive-likelihood ratio (LR+) for this cut-off value were 61.7%, 84.6%, 93.6%, 37.5%, 0.415, and 4.98, respectively.
  
  
  CONCLUSIONS
  PCT can be used as a predictive marker for sepsis-induced acute kidney injury in patients with symptoms of infection.
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, PR China.
authors.forename: Xin
authors.initials: X
authors.lastname: Nie
authors.forename: Bin
authors.initials: B
authors.lastname: Wu
authors.forename: Yong
authors.initials: Y
authors.lastname: He
authors.forename: Xunbei
authors.initials: X
authors.lastname: Huang
authors.forename: Zhongqiu
authors.initials: Z
authors.lastname: Dai
authors.forename: Qiang
authors.initials: Q
authors.lastname: Miao
authors.forename: Haolan
authors.initials: H
authors.lastname: Song
authors.forename: Tongxing
authors.initials: T
authors.lastname: Luo
authors.forename: Baoxiu
authors.initials: B
authors.lastname: Gao
authors.forename: Lanlan
authors.initials: L
authors.lastname: Wang
authors.forename: Guixing
authors.initials: G
authors.lastname: Li
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000175:diagnosis / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000378:metabolism; D012772:Shock, Septic / Q000097:blood* / Q000175:diagnosis / Q000378:metabolism; D055815:Young Adult
chemical_list: C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide