Pathfast presepsin assay for early diagnosis of systemic inflammatory response syndrome in patients with nephrolithiasis.
It is relatively difficult to diagnose bacterial sepsis in nephrolithiasis patients. The aim of the study is to evaluate the diagnostic ability of presepsin in the differential diagnosis including SIRS, infection, or sepsis and to compare its diagnostic value with other markers, mainly as CRP, procalcitonin (PCT), and white blood cell (WBC) in patients of nephrolithiasis presenting with SIRS. 39 patients of nephrolithiasis who were diagnosed as SIRS were prospectively investigated. Plasma presepsin was detected by Pathfast presepsin assay system; CRP and PCT were measured as well. Additionally, 25 nephrolithiasis patients without SIRS were included. At all timing samples, patients were classified as SIRS or non-SIRS group. Median plasma presepsin levels were significantly increased in the SIRS group compared with non-SIRS group (452 pg/mL versus 178 ng/mL, P < 0.001), and presepsin was markedly elevated even in the early stage of SIRS (584 pg/mL 6 h, 660 pg/mL 24 h versus 452 pg/mL, P < 0.001). According to the receiver-operating characteristic (ROC) analysis, presepsin demonstrated a high diagnostic value compared with either PCT or CRP. In the early stage of SIRS, presepsin remained a highly sensitive (74.7%) and specific (88.4%) diagnostic marker compared with either PCT, CRP, or WBC. Moreover, the areas under the curve (AUCs) of presepsin (84.6%) were also superior to those seen in either PCT (79.6%) or CRP (71.8%). Thus plasma presepsin levels have comparable performance in SIRS for patients with nephrolithiasis.
Department of Urology, First Affiliated Hospital of Jiaxing Medical College, Jiaxing 314000, China.
Yan-song
YS
Hou
Department of Urology, First Affiliated Hospital of Jiaxing Medical College, Jiaxing 314000, China.
Hua
H
Wang
Department of Urology, First Affiliated Hospital of Jiaxing Medical College, Jiaxing 314000, China.
Hao
H
Chen
Department of Urology, First Affiliated Hospital of Jiaxing Medical College, Jiaxing 314000, China.
Ling-feng
LF
Wu
Department of Urology, First Affiliated Hospital of Jiaxing Medical College, Jiaxing 314000, China.
Lin-feng
LF
Lu
Department of Urology, First Affiliated Hospital of Jiaxing Medical College, Jiaxing 314000, China.
Yi
Y
He
D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000473:pathology*; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000097:blood* / Q000150:complications; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors / Q000097:blood; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000150:complications
C000606589:CALCA protein, human; D018950:Lipopolysaccharide Receptors; D010446:Peptide Fragments; D011498:Protein Precursors; C000594167:presepsin protein, human; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide