Clinical Usefulness of Procalcitonin as a Predictive Marker in Accordance with the Severity of Female Patients with Uncomplicated Acute Pyelonephritis

Young-Joo Kim

doi:10.14777/uti.2016.11.03.109

Journal List > Urogenit Tract Infect > v.11(3) > 1084192

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Kim: Clinical Usefulness of Procalcitonin as a Predictive Marker in Accordance with the Severity of Female Patients with Uncomplicated Acute Pyelonephritis

Original Article

Urogenit Tract Infect 2016;11(3):109-113.

Published online: 19 January 2016

DOI: https://doi.org/10.14777/uti.2016.11.03.109

Clinical Usefulness of Procalcitonin as a Predictive Marker in Accordance with the Severity of Female Patients with Uncomplicated Acute Pyelonephritis

Young-Joo Kim

epartment of Urology, Jeju National University Hospital, Jeju, Korea

Correspondence to: Young-Joo Kim http://orcid.org/0000-0001-5580-4338 Department of Urology, Jeju National University Hospital, 15 Aran 13-gil, Jeju 63241, Korea Tel: +82-64-717-1760, Fax: +82-64-717-1131 E-mail: kurology@jejunu.ac.kr

Received 25 October 2016 Revised 18 November 2016 Accepted 28 November 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

Acute pyelonephritis (APN) is accompanied by bacteremia and has a high incidence of mortality. Currently, there is a limited number of rapid diagnostic tests that can predict the severity of infection and suitable treatments for patients with APN. Herein, we determined whether serum procalcitonin (PCT) is a useful predictive and early cognitive marker according to the severity of APN.

Materials and Methods:

Patients were divided into four groups according to the severity of infection: (1) No systemic inflammatory response syndrome (SIRS), (2) SIRS, (3) severe sepsis, and (4) septic shock. We measured the inflammatory biomarkers—PCT, C-reactive protein (CRP), and erythrocyte sedimentation rate. One way ANOVA analysis was performed between the measured infection markers and the severity of infection. The p-value of less than 0.05 was considered by the post-hoc multiple comparisons.

Results:

A total of 381 patients with APN were divided into four groups: (1) no SIRS (n=126, 33.1%), (2) SIRS (n=185, 48.6%), (3) severe sepsis (n=47, 12.3%), and (4) septic shock (n=23, 6.0%). PCT (p＜0.001) and CRP (p=0.002) showed a significant difference among the group. Greater severity of infection grade was associated with higher PCT and CRP values. According to the multivariate analysis, there was a statistically significant difference of PCT among all grades.

Conclusions:

The serum PCT was a helpful marker for predicting severity of APN. Moreover, be a useful predictor of sepsis and septic shock.

Keywords: Procalcitonin, C-reactive protein, Pyelonephritis

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Fig. 1.

Procalcitonin (PCT) increased depending on the infection severity (p<0.001). PCT did show all significant differences among four subgroups. SIRS: systemic inflammatory response syndrome.

Fig. 2.

C-reactive protein (CRP) increased depending on the infection severity (p=0.002). However, there was no difference in CRP between severe sepsis and septic shock (p=0.851). SIRS: systemic inflammatory response syndrome.

Table 1.

Assessment of the severity grade of sepsis by related parameters (n=381)

Parameter	No SIRS	SIRS	Severe sepsis	Septic shock	p-value
No. of patients	126 (33.1)	185 (48.6)	47 (12.3)	23 (6.0)
Age (y)	46.11±14.27	45.76±15.86	53.43±12.42	63.23±16.32	0.854
Temperature (^oC)	38.06±1.86	38.08±0.85	38.08±0.91	38.13±0.83	0.605
WBC (×10³/mm³)	8.7±3.4	11.8±3.9	9.3±4.3	8.1±4.1	0.681
PLT (×10³/mm³)	225.3±89.7	211.3±97.2	216.4±102.2	199.2±103.7	0.136
PCT (ng/ml)	0.12±0.04	1.30±0.42	7.10±2.11	15.23±4.43	＜0.001^a)
CRP (mg/dl)	38.72±21.86	88.03±15.86	96.18±37.43	132.76±45.68	0.002^a)
ESR (mm/h)	45.76±25.11	54.23±15.86	57.45±36.18	58.05±20.24	0.816

Values are presented as number (%) or mean±standard deviation.

SIRS: systemic inflammatory response syndrome, WBC: white blood cell, PLT: platelet, PCT: procalcitonin, CRP: C-reactive protein, ESR: erythrocyte sedimentation rate.

^a) Statistical significance.

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