Procalcitonin: diagnostic value in systemic infections in chronic kidney disease or renal transplant patients

Purpose Although procalcitonin (PCT) has been described as a marker of infection and inflammation, it has not been extensively studied in patients with chronic kidney disease (CKD), end stage renal disease, or renal transplant. PCT was routinely tested in 82 (56 dialyzed patients and 28 renal transplant recipients) consecutive cases with a strong clinical suspicion of infection, during a 6-month period, in a single referral unit. During the study period, 58/82 cases had confirmed infections as per definition. Patients with confirmed infections had higher values for PCT [median = 2.5 ng/mL, interquartile range (IR) = 0.9-5 ng/mL] than those without (median = 0.3 ng/mL, IR = 0.1-0.5 ng/mL), p < 0.001. Overall, for a cutoff value of 0.5 ng/mL, the sensitivity of the test was 93.1 % and the specificity 78.6. Our data indicate that significantly elevated PCT concentrations offer good sensitivity and specificity for the early diagnosis of systemic bacterial infection in patients with CKD.