Background/AimsSerum procalcitonin (PCT) levels are low in healthy individuals but are elevated in patients with a serious bacterial infection or sepsis. In this study, we examined the ability of serum PCT concentration to diagnose infections in end-stage renal disease (ESRD) patients, and sought to determine an appropriate threshold level.MethodsSerum PCT levels were measured in ESRD patients on antibiotic therapy for a suspected bacterial infection (ESRD infection [iESRD] group, n = 21), and compared with those of ESRD patients on hemodialysis with no sign of infection (ESRD control [cESRD] group, n = 20).ResultsThe mean serum PCT concentration of the iESRD group was significantly higher than in the cESRD group (2.95 ± 3.67 ng/mL vs. 0.50 ± 0.49 ng/mL, p = 0.006), but serum PCT concentrations did not correlate with severity of infection. The optimized threshold level derived for serum PCT was 0.75 ng/mL, rather than the currently used 0.5 ng/mL; this threshold demonstrated a sensitivity and specificity of 76.2% and 80.0% for infection and 100% and 60.6% for systemic inflammatory response syndrome, respectively, compared with the cutoff of 0.5 ng/mL.ConclusionsThis study suggests that serum PCT at a cutoff value of 0.75 ng/mL is an appropriate indicator of infection in ESRD patients.

This study inquired the relationship between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and left ventricular (LV) dysfunction and extracellular water in continuous ambulatory peritoneal dialysis (CAPD) patients. We conducted a cross-sectional study of 30 CAPD patients. Each patient was admitted to the department of internal medicine, Chosun University Hospital between February and October, 2006. Echocardiography was performed using HDI 5000, allowing M-mode, two-dimensional measurement. A multifrequency bioimpedance analyzer was used; extracellular water was calculated as a percentage of total body water and was understood as the index of volume load of CAPD patients. The mean age was 47±12 years. Underlying causes of renal failure were 14 with diabetes mellitus, 7 with hypertension, and 9 with chronic glomerulonephritis. The mean serum NT-proBNP level was 14236.56 (83-35,000) pg/mL. LV mass index and LV ejection fraction were 151.67±42.5 g/m2 and 57.48±12.9%, respectively. The mean extracellular water was 35.97±1.04%. Serum NT-proBNP levels correlated positively with LV mass index (r=0.768, p=0.01) and extracellular water (r=0.866, p=0.01) and negatively with LV ejection fraction (r=-0.808, p=0.01). Serum NT-proBNP levels significantly correlated with LV mass index, LV ejection fraction, and extracellular water. Therefore, serum NT-proBNP levels can be a clinical predictive marker for LV hypertrophy, LV dysfunction, and volume status in CAPD patients.

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