Diagnostic accuracy of procalcitonin and presepsin for infectious disease in patients with acute kidney injury

• Procalcitonin (PCT) and presepsin (PSEP) are sepsis markers.
• Diagnostic accuracy of PCT/PSEP was tested in acute kidney injury (AKI) patients.
• AUCs of PSEP were higher than those of PCT in AKI and non-AKI groups.
• Higher levels of PCT and PSEP in AKI patients may be related to severity.
• PCT and PSEP are infection markers in AKI, but different cutoffs must be used.

Procalcitonin (PCT) and presepsin (PSEP) are sepsis markers, but their diagnostic accuracy may be compromised in acute kidney injury (AKI). We evaluated their diagnostic accuracy in patients with/without AKI. This retrospective study comprised 91 patients with at least one criterion of systematic inflammatory response syndrome. AKI markers plasma neutrophil gelatinase-associated lipocalin (NGAL), plasma cystatin C (CysC), and estimated glomerular filtration rate (eGFR) were measured upon hospital admission and on days 1, 3, 5, and 7. Patients were divided into non-AKI and AKI groups. APACHE II severity scores were determined. PCT and PSEP levels were increased significantly in non-AKI and AKI patients with infection. NGAL, CysC, and eGFR in patients with infection were associated with PCT, PSEP, and APACHE II score, and levels of PCT and PSEP were correlated significantly with disease severity. PCT and PSEP are useful markers of bacterial infections in AKI but different thresholds should be applied.