title: Pro-calcitonin and inflammation in chronic hemodialysis.
abstract: Procalcitonin (PCT) has emerged as a marker of infection, a frequent complication in hemodialysis (HD). We analyzed PCT levels in chronic non-acutely infected HD subjects, assessed its correlation with inflammatory and nutritional markers and propose a PCT reference value for non-infected HD patients. In an observational cross-sectional study, 48 chronic HD patients and 36 controls were analyzed.
  
  
  METHODS
  age, gender, time on HD; diabetes; vascular access, PCT, C-reactive protein (CRP), albumin, malnutrition inflammatory score (MIS), hematocrit, leukocyte count, and body mass index (BMI). Subsequently, control (G1, n = 36, 43%) vs. non-infected patients (G2, n = 48, 57%) groups were compared. In control subjects (G1), age: 54.3 ± 13.7 years, range (r): 30-81; males: 19 (53%); median PCT 0.034 ng/ml (r: 0.02-0.08); median CRP 0.80 mg/ dl (r: 0.36-3.9); p95 PCT level: 0.063 ng/ml. In G2, age: 60.2 ± 15.2 years; males 32 (67%), time on HD: 27.0 ± 24.4; diabetics: 19 (32%); median PCT: 0.26 ng/ml (r: 0.09-0.82); CRP: 1.1 mg/dl (r: 0.5-6.2); p95 PCT level: 0.8 ng/ml. In control subjects, PCT and CRP were significantly lower than in G2: PCT: 0.034 vs. 0.26 ng/ml, p = 0.0001; CRP: 0.8 vs. 1.1 mg/dl, p = 0.0004. PCT-CRP correlation in G2: p = 0.287, p = 0.048. PCT and CRP concentrations are elevated in chronic non-acutely infected HD subjects, independently of infection, diabetes and vascular access. A p95 PCT level of 0.8 ng/ml may be considered as the upper normal reference value in non-acutely infected HD subjects. The PCT cut-off level in HD is yet to be determined in HD.
authors.affiliation: Servicio de Nefrología, Hospital Británico de Buenos Aires.
authors.forename: Hernán
authors.initials: H
authors.lastname: Trimarchi
authors.forename: Mariana
authors.initials: M
authors.lastname: Dicugno
authors.forename: Alexis
authors.initials: A
authors.lastname: Muryan
authors.forename: Fernando
authors.initials: F
authors.lastname: Lombi
authors.forename: Leticia
authors.initials: L
authors.lastname: Iturbe
authors.forename: María S
authors.initials: MS
authors.lastname: Raña
authors.forename: Pablo
authors.initials: P
authors.lastname: Young
authors.forename: Karin
authors.initials: K
authors.lastname: Nau
authors.forename: Romina
authors.initials: R
authors.lastname: Iriarte
authors.forename: Vanesa
authors.initials: V
authors.lastname: Pomeranz
authors.forename: Mariano
authors.initials: M
authors.lastname: Forrester
authors.forename: Alejandra
authors.initials: A
authors.lastname: Karl
authors.forename: Mirta
authors.initials: M
authors.lastname: Alonso
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D012016:Reference Values; D006435:Renal Dialysis / Q000009:adverse effects*; D012737:Sex Factors; D013997:Time Factors; D014657:Vasculitis / Q000097:blood* / Q000209:etiology
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide
keywords: C-reactive protein; hemodialysis; inflammation; procalcitonin