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首页> 外文期刊>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：在社区医院肾功能受损患者感染最佳Procalcitonin阈值

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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：降钙素原（PCT）是一种有助于识别细菌感染的生物标志物，但在肾功能不全的情况下很难解释，即使在没有感染的情况下，也会升高PCT。目的：确定肾功能不全合并肺炎或败血症患者的最佳PCT阈值，以确定感染。方法：对2018年至2019年期间肌酐清除率≤60ml/min且PCT水平较高的住院患者进行回顾性分析。一位药剂师对研究结果视而不见，根据预先确定的标准将患者分为感染者和非感染者。进行受试者操作特征曲线分析，以确定总体最佳PCT阈值，以及慢性肾病（CKD）、急性肾损伤（AKI）和终末期肾病（ESRD）患者亚组的最佳PCT阈值。获得了机构审查委员会的批准。结果：共有198名患者被纳入研究（99名感染者，99名非感染者）。AKI、CKD和ESRD亚组的最佳阈值分别为1.5 ng/mL、0.1 ng/mL和1.75 ng/mL。结论：本研究结果表明PCT阈值与肾功能不全类型有关。这些结果不同于传统公认的脓毒症PCT阈值0.5 ng/mL和肺炎PCT阈值0.25 mg/mL。未来的研究应该确定ESRD和CKD患者人群中合适的PCT阈值。

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