title: Procalcitonin cannot be used as a biomarker of infection in heart surgery patients with acute kidney injury.
abstract: We intended to assess how acute kidney injuy impacts on procalcitonin levels in cardiac surgery patients, with or without infection, and whether procalcitonin might be used as a biomarker of infection in acute kidney injuy.
  
  
  
  A case-control study was designed which included patients that had had cardiac surgery between January 2011 and January 2015. Every patient developing severe sepsis or septic shock (n = 122; 5.5%) was enrolled. In addition, consecutive cardiac surgery patients during 2013 developing systemic inflammatory response syndrome (n = 318) were enrolled. Those recruited 440 patients were divided into 2 groups, according to renal function.
  
  
  
  Median procalcitonin levels were significantly higher during the 10 postoperative days in the acute kidney injury patients. Regression analysis showed that postoperatory day, creatinine, white blood cells and infection were significantly (P < .0001) associated to serum procalcitonin level. In patients with creatinine ≥2, median procalcitonin levels were similar in infected and non-infected patients. Only when creatinine was less than 2 mg/L, the median procalcitonin levels were significantly higher in patients with infection, as compared to those with no infection.
  
  
  
  In acute kidney injuy patients, high procalcitonin levels are a marker of acute kidney injuy but will not be able to differentiate infected from non-infected patients.
authors: BioCritic. Group for biomedical Research in Critical care Medicine, Valladolid, Spain; Department of Anesthesiology and Reanimation, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: María
authors: M
authors: Heredia-Rodríguez
authors: Department of Cardiovascular Surgery, Hospital Universitario de La Princesa, Madrid, Spain. Electronic address: jbustamantemunguira@gmail.com.
authors: Juan
authors: J
authors: Bustamante-Munguira
authors: Department of Pharmacology and Therapeutics, Valladolid University Physicians College, Valladolid, Spain.
authors: Inmaculada
authors: I
authors: Fierro
authors: BioCritic. Group for biomedical Research in Critical care Medicine, Valladolid, Spain; Department of Anesthesiology and Reanimation, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: Mario
authors: M
authors: Lorenzo
authors: Department of Anesthesiology and Reanimation, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: Pablo
authors: P
authors: Jorge-Monjas
authors: BioCritic. Group for biomedical Research in Critical care Medicine, Valladolid, Spain; Department of Anesthesiology and Reanimation, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: Esther
authors: E
authors: Gómez-Sánchez
authors: Department of Cardiovascular Surgery, Hospital Universitario de La Princesa, Madrid, Spain.
authors: Francisco J
authors: FJ
authors: Álvarez
authors: Department of Anesthesiology, The Ohio State University, Wexner Medical Center, Columbus, OH.
authors: Sergio D
authors: SD
authors: Bergese
authors: BioCritic. Group for biomedical Research in Critical care Medicine, Valladolid, Spain; Department of Microbiology, Valladolid University Physicians College, Valladolid, Spain.
authors: José María
authors: JM
authors: Eiros
authors: BioCritic. Group for biomedical Research in Critical care Medicine, Valladolid, Spain; Infection & Immunity Medical Investigation group, Hospital Clínico Universitario-IECSCYL, Valladolid, Spain.
authors: Jesús F
authors: JF
authors: Bermejo-Martin
authors: BioCritic. Group for biomedical Research in Critical care Medicine, Valladolid, Spain; Department of Anesthesiology and Reanimation, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: José I
authors: JI
authors: Gómez-Herreras
authors: BioCritic. Group for biomedical Research in Critical care Medicine, Valladolid, Spain; Department of Anesthesiology and Reanimation, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
authors: Eduardo
authors: E
authors: Tamayo
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000150:complications; D015415:Biomarkers / Q000097:blood*; D002116:Calcitonin / Q000097:blood*; D006348:Cardiac Surgical Procedures; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012772:Shock, Septic / Q000097:blood / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D002116:Calcitonin
keywords: Acute kidney injury; Cardiac surgery; Infection; Inflammatory response; Postoperative care; Renal function failure