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Serum procalcitonin levels predict acute kidney injury in critically ill patients
Author(s) -
Jeeha Rajeev,
Skinner David L,
De Vasconcellos Kim,
Magula Nombulelo P
Publication year - 2018
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13174
Subject(s) - medicine , procalcitonin , acute kidney injury , septic shock , sepsis , kidney disease , intensive care unit , incidence (geometry) , univariate analysis , retrospective cohort study , intensive care medicine , multivariate analysis , physics , optics
Aim To determine whether admission procalcitonin (PCT) was associated with the subsequent development of acute kidney injury (AKI) in a general population of critically ill patients. Methods The study was a retrospective observational study conducted in a multidisciplinary intensive care unit (ICU) over a period of 1 year. Adult patients who had a PCT performed on admission and who did not have chronic kidney disease (CKD) or AKI on admission, were evaluated for the development of AKI within the first week of ICU admission, according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The association between PCT on admission and the development of AKI was explored for the entire cohort and for septic and non‐septic subgroups. Results Two hundred and one patients were included in the study. The incidence of AKI in the first 7 days of ICU admission was 36.8%. PCT, age, the presence of shock on admission, and sepsis were significantly associated with AKI on univariate analysis. Multivariable analysis of the entire cohort revealed that age, shock and sepsis remained independent predictors of AKI, while PCT was no longer significant. When the septic and non‐septic patients were analyzed separately a PCT ≥10 ng/mL remained the only significant predictor of AKI in the non‐septic patients (OR 4.430; 95% CI 1.464–13.399), but was not an independent predictor of AKI in septic patients. Conclusion The main finding of this study was the significant association of an elevated PCT on admission with the development of AKI in the non‐septic patient. An elevated PCT in a non‐septic patient identifies a patient at increased risk of AKI. PCT requires further study as a novel biomarker of AKI in non‐septic patients.