Comparison of procalcitonin levels before and after hemodialysis in patients with chronic renal failure and hemodialysis treatment

In patients with chronic renal failure (chronic kidney disease = CKD), the most common cause of hospitalization is infections. It is thought that PCT levels will be increased in these patients based on the assumption that procalcitonin (PCT) can be filtered by the renal glomerule and absorbed by the renal tubules, compared to the general population, the values may be different. The aim of this study is to determine whether procalcitonin level was affected or not affected by HD session in infected and non-infected hemodialysis (HD) patients, to determine the effect of hemodialysis membrane and dialyser, to determine the physiological variation of PCT in non-infected patients, to establish cut-off value and to provide economic benefit as well as preventing morbidity and mortality by making early diagnosis of infected patients. In our study, patients receiving hemodialysis (HD) treatment, routinely; , complete blood count, biochemical tests such as liver, kidney function tests, complete urine tests, and biomarkers such as C-reactive protein (CRP), PCT were received, in the later process, CRP and procalcitonin were measured weekly for four weeks; after HD session, the procalcitonin measurement was repeated and the statistical analysis of the effect of the dialysis session was performed. In the study period 26 patients with infectious findings defined as infective case group, 66 patients without infectious findings were defined as the control group. In the control group, the decrease in PCT value after HD was statistically significant in patients receiving HD with high flow dialyser (p: 0.003). The decrease in PCT value was statistically significant in patients receiving low flow dialyser in the infected case group and in the control group in the second week of treatment (p: 0.007 p: 0.001, respectively). There was a positive correlation between CRP and PCT (rho: 0.502). In the first week, for PCT and CRP taken before HD, PCT measured after HD, area under the curve (EAA: 0.828 0.860 0.822 cut-off value: 0.59 20 1.04 p: 0.000 0.001 0.000 sensitivity 76,9 % 80,7% 69,2% specificity 81.8%, 83.3%, 90.9% was revealed. As a result, 0.5 ng / ml cut-off value can be taken for PCT in patients without infectious findings, CRP-PCT correlated, in non-infected patients receiving high-flow dialyser, there was a decrease in PCT values, in addition to the fact that PCT is not affected by invasive procedures and useful in the diagnosis of systemic bacterial infections, CRP taken before HD may be a guide. Keywords: C-reactive protein, Procalcitonin, Infection, Chronic renal failure (Chronic kidney disease), Hemodialysis