Procalcitonin cannot be used as a biomarker of infection in heart surgery patients with acute kidney injury

作者：Heredia Rodriguez Maria; Bustamante Munguira Juan^*; Fierro Inmaculada; Lorenzo Mario; Jorge Monjas Pablo; Gomez Sanchez Esther; Alvarez Francisco J; Bergese Sergio D; Maria Eiros Jose; Bermejo Martin Jesus F; Gomez Herreras Jose I; Tamayo Eduardo

来源：Journal of Critical Care, 2016, 33: 233-239.

DOI：10.1016/j.jcrc.2016.01.015

• Acute kidney injury
• Renal function failure
• Infection
• Cardiac surgery
• Inflammatory response
• Postoperative care

Purpose: 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.
Material and Methods: 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.
Results: Median procalcitonin levels were significantly higher during the 10 postoperative clays 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 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.
Conclusions: In acute kidney injury patients, high procalcitonin levels are a marker of acute kidney injuy but will not be able to differentiate infected from non-infected patients.

• 出版日期2016-6