ArticleOpen forum infectious diseases2014
Sensitivity and specificity of procalcitonin in predicting bacterial infections in patients with renal impairment.
Article in Open forum infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic value of procalcitonin for bacterial infections in patients undergoing hemodialysis: a systematic review and meta-analysis.Renal failure · 2022Pooled it
- Procalcitonin kinetics in critically ill patients: a retrospective analysis of the impact of renal dysfunction and renal replacement therapy.Journal of anesthesia, analgesia and critical care · 2026Article
- Quantifying the Relationship Between Renal Function and Procalcitonin: A Study of 14 431 Blood Cultures.Open forum infectious diseases · 2025Article
- Procalcitonin levels in septic and nonseptic subjects with AKI and ESKD prior to and during continuous kidney replacement therapy (CKRT).Critical care (London, England) · 2025Article
- Changes of Procalcitonin Kinetics According to Renal Clearance in Critically Ill Patients with Primary Gram-Negative Bloodstream Infections.Infectious diseases & clinical microbiology · 2024Article
- Multidrug-Resistant Sepsis: A Critical Healthcare Challenge.Antibiotics (Basel, Switzerland) · 2024Review
- Procalcitonin Guided Antibiotic Stewardship.Biomarker insights · 2024Review
- Bacterial co-infection at hospital admission in patients with COVID-19.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Observational
- Clinical value of procalcitonin in critically ill patients infected by SARS-CoV-2.The American journal of emergency medicine · 2021Observational
- Host Diagnostic Biomarkers of Infection in the ICU: Where Are We and Where Are We Going?Current infectious disease reports · 2021Review
- Diagnostic Challenges in Sepsis.Current infectious disease reports · 2021Review
- Determination of the Optimal Procalcitonin Threshold for Infection in Patients With Impaired Renal Function at a Community Hospital.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2020Article
- Procalcitonin in hemodialysis patients presenting with fever or chills to the emergency department.Internal and emergency medicine · 2020Article
- Association between acute kidney injury and serum procalcitonin levels and their diagnostic usefulness in critically ill patients.Scientific reports · 2019Article
- Predictive value of procalcitonin for diagnosis of infections in patients with chronic kidney disease: a comparison with traditional inflammatory markers C-reactive protein, white blood cell count, and neutrophil percentage.International urology and nephrology · 2017Article
- Presepsin teardown - pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis.World journal of gastroenterology · 2016Article
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4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is unclear whether procalcitonin is an accurate predictor of bacterial infections in patients with renal impairment, although it is used as a biomarker for early diagnosis of sepsis. We determined the sensitivity, specificity, positive and negative predictive values, accuracy and best predictive value of procalcitonin for predicting bacterial infection in adult patients with severe renal impairment.
methodsRetrospective study at a single-center community teaching hospital involving 473 patients, ages 18-65, with Modification of Diet in Renal Disease eGFR ≤30 ml/min per 1.73 m(2), admitted between January 2009 and June 2012, with 660 independent hospital visits. A positive or negative culture (blood or identifiable focus of infection) was paired to the highest procalcitonin result performed 48 hours before or after collecting the culture.
resultsThe sensitivity and specificity to predict bacterial infection, using a procalcitonin level threshold of 0.5 ng/mL, was 0.80 and 0.35 respectively. When isolating for presence of bacteremia, the sensitivity and specificity were 0.89 and 0.35 respectively. An equation adjusting for optimum thresholds of procalcitonin levels for predicting bacterial infection at different levels of eGFR had a sensitivity and specificity of 0.55 and 0.80 respectively.
conclusionsProcalcitonin is not a reliably sensitive or specific predictor of bacterial infection in patients with renal impairment when using a single threshold. Perhaps two thresholds should be employed, where below the lower threshold (i.e. 0.5 ng/mL) bacterial infection is unlikely with a sensitivity of 0.80, and above the higher threshold (i.e. 3.2 ng/mL) bacterial infection is very likely with a specificity of 0.75.
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