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Med Intensiva. 2018 Oct;42(7):399-408. doi: 10.1016/j.medin.2017.12.004. Epub 2018 Feb 9.

Relationship between acute kidney injury and serum procalcitonin (PCT) concentration in critically ill patients with influenza infection.

[Article in English, Spanish]

Author information

1
Critical Care Department, Hospital Universitari de Tarragona Joan XXIII/IISPV/URV/CIBERes, Tarragona, Spain. Electronic address: ahr1161@yahoo.es.
2
Division of Pulmonary Diseases and Critical Care Medicine University of Texas Health Science Center at San Antonio San Antonio, TX, USA.
3
Critical Care Department, Hospital Universitari de Tarragona Joan XXIII/IISPV/URV/CIBERes, Tarragona, Spain.
4
Critical Care Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
5
Critical Care Department, Hospital Dr. Negrín, Las Palmas de Gran Canaria, Spain.
6
Division of Pulmonary, Critical Care and Sleep Medicine, University of Louisville and Robley Rex VA Medical Center, Louisville, KY, USA.
7
Critical Care Department, Hospital Docente de Calderón, Quito, Ecuador.
8
Critical Care Department, ParcTaulí Hospital/CIBERes, Sabadell, Spain.
9
Multidisciplinary Intensive Care Research Organization (MICRO), Department of Anaesthesia and Critical Care, St James's University Hospital, Trinity Centre for Health Sciences, Dublin, Ireland.

Abstract

INTRODUCTION:

Serum procalcitonin (PCT) concentration could be increased in patients with renal dysfunction in the absence of bacterial infection.

OBJECTIVE:

To determine the interactions among serum renal biomarkers of acute kidney injury (AKI) and serum PCT concentration, in patients admitted to the intensive care unit (ICU) due to lung influenza infection.

DESIGN:

Secondary analysis of a prospective multicentre observational study.

SETTING:

148 Spanish ICUs.

PATIENTS:

ICU patients admitted with influenza infection without bacterial co-infection. Clinical, laboratory and hemodynamic variables were recorded. AKI was classified as AKI I or II based on creatinine (Cr) concentrations (≥1.60-2.50mg/dL and Cr≥2.51-3.99mg/dL, respectively). Patients with chronic renal disease, receiving renal replacement treatment or with Cr>4mg/dL were excluded. Spearman's correlation, simple and multiple linear regression analysis were performed.

INTERVENTIONS:

None.

RESULTS:

Out of 663 patients included in the study, 52 (8.2%) and 10 (1.6%) developed AKI I and II, respectively. Patients with AKI were significantly older, had more comorbid conditions and were more severally ill. PCT concentrations were higher in patients with AKI (2.62 [0.60-10.0]ng/mL vs. 0.40 [0.13-1.20]ng/mL, p=0.002). Weak correlations between Cr/PCT (rho=0.18) and Urea (U)/PCT (rho=0.19) were identified. Simple linear regression showed poor interaction between Cr/U and PCT concentrations (Cr R2=0.03 and U R2=0.018). Similar results were observed during multiple linear regression analysis (Cr R2=0.046 and U R2=0.013).

CONCLUSIONS:

Although PCT concentrations were slightly higher in patients with AKI, high PCT concentrations are not explained by AKI and could be warning sign of a potential bacterial infection.

KEYWORDS:

Creatinina; Creatinine; Disfunción renal; Gripe; Influenza; Procalcitonin; Procalcitonina; Renal dysfunction; Urea

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