The Role of Procalcitonin and C-Reactive Protein as An Indicator of Bacterial Infection in Chronic Kidney Disease Undergoing Hemodialysis

Abstract

Background: This is a cross- sectional study that included a bacteriology and biochemical markers comparative between Procalcitonin (PCT), and C-reactive protein in chronic hemodialysis patients Aim of the study: The purpose of this study was to clarify the diagnostic accuracy of the use of Procalcitonin ( PCT) level and C-reactive protein,and to prove the value of these markers in the diagnosis of infections in patients with Infections-CKD and Non-infections CKD.To establish a new cut-off value for PCT to eliminate confusion in the diagnosis and treatment of bacterial infections in hemodialysis (HD) patients. Methodology: Blood samples were collected, approximately 10 ml with complete information achronic kidney disease n the blood was divided into three parts, one part for culture, second part to separate by the centrifuge and the serum was used to measurement the levels of Procalcitonin, and C- reactive protein (CRP), and the Third part was used to performed Complete blood count (CBC). Results: Through comparing the results statistically, this study showed that the older people were more likely to have chronic renal failure than young; moreover, the present study showed that the rate of chronic renal failure was higher in females by 63% versus 37% for males, as the study showed the most common cause of chronic kidney failure is hypertension, and the least it is diabetes. In our current study, there were 46 patients who had a positive culture result with a percentage of 34%, and 35% of them were caused by Gram-positive bacteria which is the highest and an average of 28 isolates and a percentage of 60.9%) and 9 isolates of Gram-negative bacteria with a percentage (19.6% )and 9 isolates (19.6%) is unknown,the system was not able to diagnose it, the isolates were diagnosed with the VITEK 2 compact system, and a sensitivity test for the bacteria that was diagnosed using the same system.While the percentage of negative culture was 66% of the total samples. The study proved that the level of the PCT is not useful in distinguishing bacterial infection and may be indicate the presence of impaired kidney function, while CRP was more sensitive and accurate in diagnosing bacterial infection in those patients. Conclusion: that PCT does not superior to CRP as an infection marker.