Relationship Between Inflammatory Markers and Infection in Chronic Kidney Disease

Abstract

Purpose: The aim of this study was to evaluate the importance of C-reactive protein (CRP) and procalcitonin (PCT) in the diagnosis and monitoring of infections in chronic kidney disease (CKD) patients. Materials and Methods: In this study, 1538 hospitalized patients in the nephrology division of Ondokuz Mayis University between March 2012 and June 2014 were evaluated. A total of 72 patients with CKD (Glomerular filtration rate <60 ml/min), treated for any bacterial infection and complete data were included. The laboratory values before and after antibiotic treatments were comp axed. Results: The median age of 72 patients was 66 (20-90) years, and 52.8% (n=38) were male. Primary reason for hospitalization was infection in 52.8% (n=38) of the patients. There was a significant decrease in CRP and PCT after infection treatment. CRP difference after treatment was significantly high in patients with positive culture. CRP, PCT and difference in PCT had no decision-making feature for the culture positivity, while the difference in CRP was determined to have a decision-making feature. Conclusion: CRP and PCT levels decreased significantly in CKD patients after infection treatment, and we confirmed that they are valuable markers in the diagnosis and follow-up of bacterial infections in CKD patients as in other patient groups. We found that the difference in CRP was predictive for culture positivity while the difference in PCT was not. We found a higher than normal CRP cut-off value (12 mg/L) in CKD patients as an indicator of infection.