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Revista Colombiana de Nefrología
On-line version ISSN 2500-5006
Abstract
CHAVEZ-INIGUEZ, Jonathan Samuel et al. Procalcitonin as a biomarker for acute kidney injury in patients with sepsis and septic shock. Rev. colom. nefrol. [online]. 2019, vol.6, n.2, pp.130-137. ISSN 2500-5006. https://doi.org/10.22265/acnef.6.2.351.
Introduction:
Up to 60% of patients with sepsis develop acute kidney injury. Procalcitonin indicates the presence of sepsis and could predict acute kidney injury.
Objectives:
To determine the values of procalcitonin as a predictive biomarker of acute renal injury and its complications in the sepsis spectrum.
Methods:
Cross-sectional study. Procalcitonin was measured during the 24 hours of hospitalization. We determined the area under the curve, standard error, sensitivity and specificity of procalcitonin values related to acute renal injury.
Results:
A total of 72 patients aged 51 years (range 18-79); 35 (48.6%) were male, 44 (61.1%) presented sepsis, 14 (19.4%) had septic shock, 11 (15.3%) severe sepsis and 3 (4.2%) sepsis-induced hypotension. We found an elevation of procalcitonin (≥0.5 ng / mL) in 54 (75%) patients; presented acute renal injury 42 (58.3%) cases; KDIGO 1 in 19 (45.2%), KDIGO 2 in 12 (28.6%) and KDIGO 3 in 11 (26.2%) patients; of them 37 (88.1%) had procalcitonin ≥0.5 ng / mL (OR 5.65, 95% CI 1.73-18.42, p <0.01). The area under the curve 0.75 (95% CI 0.63 - 0.86 p <0.0001); the value of procalcitonin of 2,565 ng / mL had the highest validity predicting acute renal injury, with sensitivity of 61.9%, specificity of 80%, a positive predictive value of44.52%, negative predictive value of 56.18%, LR + of 0.80 and an LR - 0.77.
Conclusion:
In the sepsis spectrum, the level of procalcitonin ≥2,565 ng / mL at hospital admission predicts acute kidney injury.
Keywords : acute renal injury; acute renal failure; biomarker; procalcitonin; sepsis; prediction.