Serum procalcitonin as a marker of infection in chronic kidney disease patients on hemodialysis in sepsis.

Introduction: The use of Procalcitonin (PCT) as a bacterial diagnostic marker is controversial in patients on hemodialysis (HD). Infections account for considerable morbidity and mortality in patients on HD. Hence, early diagnosis of bacterial infections is important to make a prognostic assessment of its severity. If PCT can be used as a primary marker for bacterial infections in patients on HD, these infections can be diagnosed and treated early. Therefore, we investigated whether PCT could function as a primary diagnostic marker of bacterial infections in patients on HD. Aim: 1) To measure and show that serum procalcitonin levels will be increased in patients with chronic kidney disease in sepsis on hemodialysis, and will be clinically significant. 2) To compare the serum procalcitonin levels in patients on hemodialysis with sepsis; with procalcitonin level of patients on hemodialysis without sepsis Methods: A total of 80 patients of chronic kidney disease on hemodialysis admitted in M S Ramaiah Hospital during the period October 2012 to september2014, were included in the study and were divided into 40 cases and 40 controls considering the inclusion and exclusion criteria. Results: Raised Serum procalcitonin was significantly more associated with CKD patients on hemodialysis in sepsis with P<0.001. When procalcitonin was measured in CKD patients on hemodialysis in sepsis, the sensitivity and specificity was 92.50, and 100.00 respectively, with a cut-off >5ng/ml. Conclusion: Procalcitonin is a good marker of bacterial infection even in patients undergoing hemodialysis. In patients undergoing hemodialysis, procalcitonin cut off level of >5ng/ml indicates sepsis.