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首页> 美国卫生研究院文献>The Journal of Pharmacy Technology : jPT : Official Publication of the Association of Pharmacy Technicians >Determination of the Optimal Procalcitonin Threshold for Infection in Patients With Impaired Renal Function at a Community Hospital
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Determination of the Optimal Procalcitonin Threshold for Infection in Patients With Impaired Renal Function at a Community Hospital

机译：社区医院肾功能受损患者感染最佳ProCalcitonin阈值的测定

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Background: Procalcitonin (PCT) is a biomarker that can help identify bacterial infections but can be difficult to interpret in the presence of renal dysfunction, which can elevate PCT even in the absence of infection. Objective: To determine the optimal PCT threshold to identify infection in patients with renal dysfunction and pneumonia or sepsis. Methods: A retrospective analysis was performed for inpatients with creatinine clearance of ≤60 mL/min and PCT level from 2018 to 2019. A pharmacist blinded to study outcomes classified patients as infected or noninfected based on predetermined criteria. Receiver operating characteristic curve analysis was performed to establish the optimal PCT threshold overall, as well as in subgroups of patients with chronic kidney disease (CKD), acute kidney injury (AKI), and end-stage renal disease (ESRD). Institutional review board approval was obtained. Results: A total of 198 patients were included in the study (99 infected, 99 noninfected). The optimal threshold in the AKI, CKD, and ESRD subgroups was determined to be 1.5 ng/mL, 0.1 ng/mL, and 1.75 ng/mL, respectively. Conclusion: The results of this study show that PCT thresholds were specific to type of renal dysfunction. These results differ from the traditionally accepted PCT threshold of 0.5 ng/mL for sepsis and 0.25 mg/mL for pneumonia. Future studies should confirm the appropriate PCT threshold in ESRD and CKD patient populations.
机译：背景：ProCalcitonin（PCT）是一种能够有助于鉴定细菌感染的生物标志物，但是难以在存在肾功能紊乱的情况下解释，即使在没有感染的情况下也能升高PCT。目的：确定最佳PCT阈值，以鉴定肾功能障碍患者感染和肺炎或败血症。方法：从2018年至2019年对肌酐清除率≤60mL/ min和PCT级别进行了回顾性分析。盲目的药剂师在研究中，将患者分类为受感染或非预定标准。进行接收器操作特征曲线分析以确定整体的最佳PCT阈值，以及慢性肾病（CKD），急性肾损伤（AKI）和末期肾病（ESRD）患者的亚组。获得机构审查委员会批准。结果：研究中共有198名患者（99例感染，99例无染色）。 AKI，CKD和ESRD亚组中的最佳阈值分别确定为1.5ng / ml，0.1ng / ml和1.75ng / ml。结论：本研究结果表明，PCT阈值是肾功能紊乱类型的特异性。这些结果与传统上接受的PCT阈值为0.5ng / ml的败血症和0.25mg / ml的肺炎。未来的研究应在ESRD和CKD患者人口中确认适当的PCT阈值。

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