血降钙素原对脓毒症相关急性肾损伤的诊断价值

doi:10.3969/j.issn.1002-1949.2018.01.018

Chinese Journal of Critical Care Medicine

2018, Vol. 38

Issue (1): 80-83 DOI: 10.3969/j.issn.1002-1949.2018.01.018

The diagnostic value of procalcitonin (PCT) in patients with sepsis-associated acute kidney injury

Wang Xue-ting, Gao Xue-hua, Guan Yin, Luo Yan-nian, Lian Fo-yan, He Nan-nan, Li Pei-jie, Cao Wen

Department of Critical Care Medicine〖XC2.TIF〗, the Second Hospital of Lanzhou University, Lanzhou 730030, China

Abstract
Figure/Table
References (13)
Related Citation (15)

Download: PDF (522 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective： To evaluate the early diagnostic value of procalcitonin (PCT) in patients with sepsis-associated acute kidney injury (SA-AKI). Methods： We collected the clinical data in the Second Hospital of Lanzhou University Critical Care MedicineⅡ in 2016. This retrospective study included 97 patients with sepsis, according to the presence of renal injuries, they were divided into Non-AKI and AKI groups, AKI 42 cases, N-AKI 55 cases. We compared the patients′ gender, age, PCT, Cys-C, IL-6, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ), sequential organ failure assessment (SOFA) between the two groups. Logistic regression was used to analyze the correlation between PCT, Cys-C, IL-6, APACHEⅡ, SOFA and SA-AKI. The receiver-operating characteristic (ROC) was drawn to compare the predictive value of the early diagnosis of SA-AKI by PCT, Cys-C and IL-6. Results： ①The single factor analysis of two groups of patients with gender and age had no statistical differences (P>0.05), PCT, Cys-C, IL-6, APACHEⅡ score, SOFA score showed statistical differences (P<0.05); ②The results of Logistic regression analysis of variables with statistical differences in single factor analysis showed: SOFA score （OR=2.395, 95% CI 1.417-4.050, P=0.001）， PCT （OR=1.592, 95% CI 1.132-3.244, P=0.018）， Cys-C（OR=1.425, 95% CI 1.120-3.237, P=0.015）， IL-6（OR=1.211, 95% CI 0.999-2.003, P=0.037）， SOFA scores, PCT, Cys - C and IL-6 were independent risk factors for SA-AKI. ③ The area under the ROC curve for PCT was 0.796, the value of diagnose SA-AKI was higher than Cys - C and IL-6. When PCT > 13.685 ng/mL, the sensitivity of diagnose SA-AKI was 59.3% and the specificity was 92.7%. Conclusion： PCT is an independent risk factor for SA-AKI, has high diagnostic value for SA-AKI in the early.

Key words： Procalcitonin (PCT)丨Interleukin-6 (IL-6)丨Cystatin C (Cys - C) 丨Acute physiology and chronic health evaluationⅡ (APACHEⅡ) 〓Sequential organ failure assessment (SOFA) 〓Sepsis associated acute kidney injury (SA-AKI)

Received: 28 August 2017

Corresponding Authors: Cao Wen, E-mail: smilecao2009@aliyun.com

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Wang Xue-ting
	Gao Xue-hua
	Guan Yin
	Luo Yan-nian
	Lian Fo-yan
	He Nan-nan
	Li Pei-jie
	Cao Wen

Cite this article:

Wang Xue-ting,Gao Xue-hua,Guan Yin, et al. The diagnostic value of procalcitonin (PCT) in patients with sepsis-associated acute kidney injury[J]. Chinese Journal of Critical Care Medicine, 2018, 38(1): 80-83.

URL:

http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2018.01.018 OR http://www.cnemergency.org.cn/EN/Y2018/V38/I1/80

［1］Thadhani R, Pascual M, Bonventre JV. Acute renal failure［J］. N Engl J Med, 1996, 334(22): 1448-1460. ［2］Payen D, Lukaszewicz AC, Legrand M, et al. A multicentre study of acute kidney injury in severe sepsis and septic shock: association with inflammatory phenotype and HLA genotype［J］. PLoS One, 2012, 7(6): e35 838.［3］Lerolle N, Nochy D, Guerot E, et al. Histopathology of septic shock induced acute kidney injury: apoptosis and leukocytic infiltration［J］. Intensive Care Med, 2010, 36(3): 471-478. ［4］Bagshaw SM, Uchino S, Bellomo R, et al. Septic acute kidney injury in critically ill patients: clinical characteristics and outcomes［J］. Clin J Am Soc Nephrol, 2007, 2(3): 431-439. ［5］Alobaidi R, Basu RK, Goldstein SL, et al. Sepsis-associated acute kidney injury［J］. Semin Nephrol, 2015, 35(1): 2-11. ［6］Bouadma L, Luyt CE, Tubach F, et al. Use of procalcitonin to reduce patients′ exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trial［J］. Lancet, 2010, 375(9713): 463-474. ［7］Jensen JU, Hein L, Lundgren B, et al. procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit:a randomized trial ［J］. Crit Care Med, 2011, 39(9): 2048-2058. ［8］Rhodes A, Evans LE, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock： 2016［J］. Intensive Care Med, 2017, 43(3):304-377. ［9］Khwaja A. KDIGO clinical practice guidelines for acute kidney injury［J］. Nephron Clin Pract, 2012, 120(4):c179-c184. ［10］方红龙,陈娟,罗建，等.血降钙素原测定对重症脓毒症患者急性肾损伤的预测价值［J］. 医学研究杂志, 2014, 43(5):70-72. ［11］Martensson J, Martling CR, Oldner A, et al. Impact of sepsis on levels of plasma cystatin C in AKI and non-AKI patients［J］. Nephrol Dial Transplant, 2012, 27(2): 576-581. ［12］Harbarth S, Holeckova K, Froidevaux C, et al. Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis［J］. Am J Respir Crit Care Med, 2001,164(3): 396-402. ［13］Kim H, Hur M, Cruz DN, et al. Plasma neutrophil gelatinase associated lipocalin as a biomarker for acute kidney injury in critically ill patients with suspected sepsis［J］. Clin Biochem, 2013, 46(15): 1414-1418.