Predictive value of procalcitonin in the early stage of continuous renal replacement therapy of sepsis-associated acute kidney injury

ObjectiveTo evaluate the prognostic value of procalcitonin (PCT) in the early stage of continuous renal replacement therapy (CRRT) of septic-associated acute kidney injury (AKI).

MethodsTwenty-five sepsis-associated AKI patients treated with CRRT were divided into the survival group (n=10) and death group (n=15) according to 28 days prognosis.At different time points after CRRT treatment, the serum PCT, white blood cell ount (WBC), C reactive protein (CRP) levels in two groups were detected, and the PCT clearance (%) was calculated.The general clinical data in two groups were recorded, and the difference of which was compared between two groups.The receiver operating curve (ROC) was used to evaluate its prognostic value.

ResultsThere was no statistical significance in the levels of serum PCT, WBC and CRP between two groups at different time points (P>0.05), but the difference of serum PCT clearance between two groups was statistically significant after 24 h of CRRT shutdown (P < 0.01).The area under the ROC curve of the clearance rates of 12 h and 24 h PCT after starting CRRT were 0.620 and 0.693, respectively.The area under the ROC curve of the clearance rate of 24 h PCT after CRRT was 0.980 (95% CI:0.934-1.000).Using 21.5% as the cut-off value, the sensitivity was 90.0%, and the specificity was 100.0%.

ConclusionsIn the early CRRT stage of sepsis-associated AKI patients, inflammatory indicators (PCT, WBC and CRP) have limited prognostic value.The clearance rate of 24 h PCT after CRRT shutdown has a high prognostic value.