Serum procalcitonin level in chronic hemodialytic patients with no evidence of bacterial infection

Background: The baseline levels of serum procalcitonin (PCT) have not been determined in patients with end-stage renal disease needing renal replacement therapy. The purpose of the present study is to verify the reference range of PCT and parameters affecting its value in patients receiving chronic hemodialysis. Methods: A total of 125 dialytic patients who had no obvious clinical signs of systemic infection were included in this prospective observational study. The PCT level was measured, and its relationships to other clinical and laboratory parameters were evaluated. Results: The baseline PCT levels of 82 male and 43 female patients were evaluated. Mean baseline PCT level was 0.24 ± 0.22 ng/ml. Sixteen (12.8 %) patients showed elevated PCT (>0.3 ng/ml) and C-reactive protein (CRP) (>0.3 mg/dl), and 11 (8.8 %) patients showed only abnormal PCT. In 9 patients (7.2 %), PCT levels exceeded 0.5 ng/ml, which is a common cutoff point for sepsis although they had no clinical signs of systemic bacterial infection. The PCT level was statistically correlated with the duration of chronic dialysis, urine volume per day, dialysis time, the serum CRP, β2-microglobulin levels, and normalized dialysis dose. Conclusions: Most dialysis patients had PCT levels within the reference range of non-dialytic individuals. However, a not negligible number of patients had higher PCT levels than the upper limit of healthy individuals, despite there being no sign of infection. Impairment of renal function and hemodialytic status may affect PCT level.