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Biomarkers and risk factors for sepsis in stage 5 chronic kidney disease: a retrospective case–control study

  • Nephrology - Original Paper
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Abstract

Purpose

To assess the predictive value of procalcitonin (PCT) in the risk of sepsis in patients with stage 5 chronic kidney disease (CKD).

Methods

A total of 373 inpatients with stage 5 CKD were retrospectively analyzed. The patients were divided into non-infection group, local infection group, and sepsis group. The clinical characteristics and inflammatory parameters including PCT, C-reactive protein (CRP), white blood cell count (WBC), and neutrophil percentage (NEU%) were compared and the receiver operating characteristic (ROC) curves to predict sepsis were plotted. Related risk factors of sepsis were analyzed by logistic regression analysis.

Results

(1) The hemodialysis ratio of sepsis group was the highest at 92.3%. PCT, CRP, and NEU% were significantly different among the three subgroups (P < 0.05 for all). Total cholesterol and low density lipoprotein (LDL) levels in sepsis group were significantly lower than that in local infection group (P < 0.05 for both). (2) CRP and WBC were unable to predict sepsis (P > 0.05 for all), while PCT and NEU% could predict sepsis with areas under the curve (AUC) of 0.838 and 0.691, respectively (P < 0.05 for all). (3) Multivariate logistic regression analysis showed that PCT > 1.650 ng/mL was a risk factor (OR = 6.926, P = 0.002) while LDL was probably a protective factor (OR = 0.336, P = 0.040) of sepsis in patients with stage 5 CKD.

Conclusions

At stage 5 CKD, the predictive value of PCT for sepsis is best among inflammatory markers, and PCT and LDL levels are independent factors of sepsis.

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Data availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

CKD:

Chronic kidney disease

PCT:

Procalcitonin

CRP:

C-reactive protein

WBC:

White blood cell count

NEU%:

Neutrophil percentage

ALAT:

Alanine aminotransferase

ASAT:

Aspartate aminotransferase

ROC:

Receiver operating characteristic

AUC:

Areas under the curve

ESRD:

End-stage renal diseases

RRT:

Renal replacement therapy

SIRS:

Systemic inflammatory response syndrome

GFR:

Glomerular filtration rate

eGFR:

Estimated glomerular filtration rate

SCr:

Serum creatinine

BUN:

Blood urea nitrogen

TCHO:

Total cholesterol

TG:

Triglyceride

LDL:

High density lipoprotein

HDL:

Low density lipoprotein

PD:

Peritoneal dialysis

HD:

Hemodialysis

CAD:

Coronary atherosclerotic disease

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Funding

This work was supported by Natural Science Foundation of China (No. 81771798).

Author information

Author notes

  1. Lijuan Jiang and Xiaonan Shao are co-first authors.

Authors and Affiliations

  1. Department of Clinical Laboratory, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China

    Lijuan Jiang

  2. Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China

    Xiaonan Shao

  3. Department of Radiology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China

    Wei Xing

  4. Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China

    Yanbei Sun

Authors
  1. Lijuan Jiang
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  2. Xiaonan Shao
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  3. Wei Xing
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  4. Yanbei Sun
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Contributions

YS and XS conceived of the study, and drafted the manuscript. LJ carried out the Lab testing. XS participated in the design of the study and performed the statistical analysis.

Corresponding author

Correspondence to Yanbei Sun.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

The study has been approved by the Ethics Committee of Soochow University.

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Jiang, L., Shao, X., Xing, W. et al. Biomarkers and risk factors for sepsis in stage 5 chronic kidney disease: a retrospective case–control study. Int Urol Nephrol 51, 691–698 (2019). https://doi.org/10.1007/s11255-018-2035-2

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  • DOI: https://doi.org/10.1007/s11255-018-2035-2

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