title: Procalcitonin levels predict acute kidney injury and prognosis in acute pancreatitis: a prospective study.
abstract: BACKGROUND
  Acute kidney injury (AKI) has been proposed as a leading cause of mortality for acute pancreatitis (AP) patients admitted to the intensive care unit (ICU). This study investigated the predictive value of procalcitonin (PCT) for AKI development and relevant prognosis in patients with AP, and compared PCT's predictive power with that of other inflammation-related variables.
  
  
  METHODS
  Between January 2011 and March 2013, we enrolled 305 cases with acute pancreatitis admitted to ICU. Serum levels of PCT, serum amyloid A (SAA), interleukin-6 (IL-6), and C reactive protein (CRP) were determined on admission. Serum PCT was tested in patients who developed AKI on the day of AKI occurrence and on either day 28 after occurrence (for survivors) or on the day of death (for those who died within 28 days).
  
  
  RESULTS
  Serum PCT levels were 100-fold higher in the AKI group than in the non-AKI group on the day of ICU admission (p<0.05). The area under the receiver-operating characteristic (ROC) curve of PCT for predicting AKI was 0.986, which was superior to SAA, CRP, and IL-6 (p<0.05). ROC analysis revealed all variables tested had lower predictive performance for AKI prognosis. The average serum PCT level on day 28 (2.67 (0.89, 7.99) ng/ml) was significantly (p<0.0001) lower than on the day of AKI occurrence (43.71 (19.24,65.69) ng/ml) in survivors, but the serum PCT level on death (63.73 (34.22,94.30) ng/ml) was higher than on the day of AKI occurrence (37.55 (18.70,74.12) ng/ml) in non-survivors, although there was no significant difference between the two days in the latter group (p = 0.1365).
  
  
  CONCLUSIONS
  Serum PCT is superior to CRP, IL-6, and SAA for predicting the development of AKI in patients with AP, and also can be used for dynamic evaluation of AKI prognosis.
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Hua-Lan
authors.initials: HL
authors.lastname: Huang
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Nie
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Cai
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Jiang-Tao
authors.initials: JT
authors.lastname: Tang
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: He
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Miao
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Hao-Lan
authors.initials: HL
authors.lastname: Song
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Tong-Xing
authors.initials: TX
authors.lastname: Luo
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Bao-Xiu
authors.initials: BX
authors.lastname: Gao
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Lan-Lan
authors.initials: LL
authors.lastname: Wang
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Gui-Xing
authors.initials: GX
authors.lastname: Li
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000150:complications*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000150:complications*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D012372:ROC Curve; D000685:Serum Amyloid A Protein
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D015850:Interleukin-6; D011498:Protein Precursors; D000685:Serum Amyloid A Protein; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide