Relationship between presepsi̇n levels and infections in dialysis patients

Objective: We planned to compare the presepsin levels of HD patients in the periods with and without infection. At the same time, presepsin was measured in the healthy control group, and presepsin levels were compared between the healthy control group and HD patients, aiming to find the threshold value of presepsin during the infection period of HD patients. Materials and Methods: Our study included 26 patients who underwent routine HD at the KTU Farabi Hospital Hemodialysis Unit between September 2021 and June 2023, as well as 25 healthy controls. When HD patients did not have an infection, we took blood samples for complete blood count, comprehensive biochemistry (such as creatinine, albumin, CRP, etc.), procalcitonin, and presepsin. Samples taken for presepsin and procalcitonin were centrifuged and stored at -80 ° C. The same procedures were repeated during the period when the patients developed infection during follow-up. The same parameters were studied in the healthy control group. The patient's sociodemographic characteristics and laboratory parameters (such as leukocyte, neutrophil count, albumin value, CRP, etc.) were recorded in the patient follow-up form. Findings: Of the 51 people in our study, 23.5% (n=12) were female and 76.5% (n=39) were male. The healthy control group had a leukocyte count of 5930 (4290-9500) /µl, a neutrophil count of 3206±751/µl, an albumin level of 44.6±1.94 g/L, a CRP level of 1.000 (0.50-8.00) mg/L, and a presepsin level of 6.762±1.81 ng/mL. The HD patients had a leukocyte count of 5845 (3490-9780) /µl, a neutrophil count of 3667±1247/µl, an albumin level of 40.0±5.42 g/L, a CRP level of 6.8 (0.3-34.1) mg/L, a presepsin level of 4.22±2.14 ng/mL, and a procalcitonin level of 0.294±0.166 μg/L. In the 13 HD patients who had an infection during the follow-up, the CRP level measured during the period with no infection was 10.63±9.60 mg/L, the presepsin level was 3.86±2.02 ng/mL, and the procalcitonin level was 0.33(0.12-0.6) μg/L, while the CRP level measured during the period when the infection developed was 105.08±75.59 mg/L, the presepsin level was 4.81±2.00 ng/mL, and the procalcitonin level was 0.75(0.13-27.9) μg/L. Conclusion: The difference between the albumin, CRP and presepsin levels of the healthy control group and hemodialysis patients measured during the infection-free period was statistically significant (p= 0.000, p= 0.000, p= 0.000, respectively). The difference between the infection markers measured during the infection period and the leukocyte, neutrophil, CRP and procalcitonin levels measured during the infection period in 13 HD patients who had an infection during the follow-up was statistically significant (p= 0.007, p= 0.001, p= 0.000, p= 0.002, respectively).