Procalcitonin as a biomarker for acute kidney injury in patients with sepsis and septic shock
PDF (Español)
HTML (Español)
PDF (Español)


acute renal injury, acute renal failure, biomarker; procalcitonin; sepsis, prediction.

How to Cite

Chávez-Iñiguez JS, Muñoz-Nevárez LA, Morraz-Mejía EF, Moreno-Alvarado RA, López-Ceja M, Montalbán-Castellanos JM, García-García G. Procalcitonin as a biomarker for acute kidney injury in patients with sepsis and septic shock. Rev. Colomb. Nefrol. [Internet]. 2019 Sep. 11 [cited 2024 Jul. 25];6(2):130-7. Available from:


Introduction: Up to 60% of patients with sepsis develop acute kidney injury. Procalcitonin indicates the presence of sepsis and could predict acute kidney injury.

Objectives: To determine the values of procalcitonin as a predictive biomarker of acute renal injury and its complications in the sepsis spectrum.

Methods: Cross-sectional study. Procalcitonin was measured during the 24 hours of hospitalization. We determined the area under the curve, standard error, sensitivity and specificity of procalcitonin values related to acute renal injury.

Results: A total of 72 patients aged 51 years (range 18-79); 35 (48.6%) were male, 44 (61.1%) presented sepsis, 14 (19.4%) had septic shock, 11 (15.3%) severe sepsis and 3 (4.2%) sepsis-induced hypotension. We found an elevation of procalcitonin (>0.5 ng/ mL) in 54 (75%) patients; presented acute renal injury 42 (58.3%) cases; KDIGO 1 in 19 (45.2%), KDIGO 2 in 12 (28.6%) and KDIGO 3 in 11 (26.2%) patients; of them 37 (88.1%) had procalcitonin >0.5 ng / mL (OR 5.65, 95% CI 1.73-18.42, p <0.01). The area under the curve 0.75 (95% CI 0.63 - 0.86 p <0.0001); the value of procalcitonin of 2,565 ng / mL had the highest validity predicting acute renal injury, with sensitivity of 61.9%, specificity of 80%, a positive predictive value of 44.52%, negative predictive value of 56.18%, LR + of 0.80 and an LR - 0.77.

Conclusion: In the sepsis spectrum, the level of procalcitonin >2,565 ng / mL at hospital admission predicts acute kidney injury.
PDF (Español)
HTML (Español)
PDF (Español)


Khwaja A. KDIGO Clinical Practice Guidelines for Acute Kidney Injury. Nephron Clin Pract. 2012; 7,120(4):179-184.

Cartin-Ceba R, Haugen EN, Iscimen R, Trillo-Alvarez C, Juncos L, Gajic O. Evaluation of “Loss” and “End stage renal disease” after acute kidney injury defined by the Risk, Injury, Failure, Loss and ESRD classification in critically ill patients. Intensive Care Med. 2009;35:2087-95.

Hoste EA, Schurgers M. Epidemiology of acute kidney injury: how big is the problem?. Crit Care Med. 2008; 36(4 Suppl):S146-51.

Suh SH, Kim CS, Choi JS, Bae EH, Ma SK, Kim SW. Acute kidney injury in patients with sepsis and septic shock: risk factors and clinical outcomes. Yonsei Med J. 2013;54(4):965-72.

Kelly KJ. Acute renal failure: much more than a kidney disease. Semin Nephrol.2006;26:105-113. 10.1016/j.semnephrol.2005.09.003

Siew ED, Peterson JF, Eden SK, Hung AM, Speroff T, Ikizler TA, et al. Outpatient nephrology referral rates after acute kidney injury. J Am Soc Nephrol. 2012; 23:305-312.

Landry DW, Oliver JA. The pathogenesis of vasodilatory shock. N Engl J Med. 2001;345:588-95. 10.1056/NEJMra002709

Zarjou A, Agarwal A. Sepsis and acute kidney injury. J Am Soc Nephrol. 2011;22(6):999-1006.

Schrier RW, Wang W. Acute Renal Failure and Sepsis. N Engl J Med. 2004; 351(2):159-69.

Neveu H, Kleinknecht D, Brivet F, Loirat P, Landais P. Prognostic factors in acute renal failure due to sepsis. Results of a prospective multicentre study. The French Study Group on Acute Renal Failure. Nephrol Dial Transplant. 1996;11(2):293-9. ndt.a027256

Al-Nawas B, Kramer I, Sha PM. Procalcitonin in the diagnosis of severe infections. Eur J Med Res.1996;1(7):331-333.

Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohuon C. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet.1993;341(8844):515-518.

Herget-Rosenthal S, Marggraf G, Pietruck F, Hüsing J, Strupat M, Philipp T, et al. Procalcitonin for accurate detection of infection in haemodialysis. Nephrol Dial Transplant. 2001;16(5):975-979.

Steinbach G, Bölke E, Grünert A, Storck M, Orth K. Procalcitonin in patients with acute and chronic renal insufficiency. Wien Klin Wochenschr (2004);116(24):849-853.

Nishikura T. The clearance of procalcitonin (PCT) during continuous veno-venous haemodiafiltration (CVVHD) [Letter]. Intens Care Med.1999;25:1198-1199.

Rau B, Steinbach G, Baumgart K, Gansauge F, Grunert A, Beger HG. The clinical value of procalcitonin in the prediction of infected necrosis in acute pancreatitis. Intensive Care Med. 2000; 26(Suppl 2):S159-64. 10.1007/BF02900730

Araujo M, Doi SQ, Palant CE, Nylen ES, Becker KL. Procalcitonin induced cytotoxicity and apoptosis in mesangial cells: implications for septic renal injury. Inflamm Res. 2013(62):887-894.

Dellinger P, Levy M, Rhodes A, Annane D, Gerlach H, et al. Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012. Crit Care Med. 2013;41(2):580-637.

KDIGO Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline for acute kidney injury. Kidney Inter. 2012;2(Suppl):1-138.

Becker Kl, Snider R, Nylen Es. Procalcitonin in sepsis and systemic inflammation: a harmful biomarker and a therapeutic target. Br J Pharmacol. 2010;159(2):253-64.

Nie X, Wu B, He Y, Huang X, Dai Z, Luo T, et al. Serum procalcitonin predicts development of acute kidney injury in patients with suspected infection. Clin Chem Lab Med. 2013;15(8):1655-61.

Nakamura Y, Murai A, Mizunuma M, Ohta D, Kawano Y, Matsumoto N, et al. Potential use of procalcitonin as biomarker for bacterial sepsis in patients with or without acute kidney injury. J Infect Chemother. 2015;21(4):257-63.

Liu Y, Guo W, Zhang J, Xu C, Yu S, et al. Urinary interleukin 18 for detection of acute kidney injury: a meta-analysis. Am J Kidney Dis. 2013;62(6):1058-67.

Susantitaphong P, Siribamrungwong M, Doi K, Noiri E, Terrin N, Jaber BL. Performance of urinary liver-type fatty acid-binding pro tein in acute kidney injury: a meta-analysis. Am J Kidney Dis. 2013;61(3):430-9.

Zhang A, Cai Y, Wang PF, Qu JN, Luo zc, Chen XD, et al. Diagnosis and prognosis of neutrophil gelatinase-associated lipocalin for acute kidney injury with sepsis: a systematic review and meta-analysis. Critical Care. 2016;20:41.

Kellum JA, Chawla LS. Cell-cycle arrest and acute kidney injury: the light and the dark sides. Nephrol Dial Transplant. 2016; 31(1):16-22.

Kurtul A, Murat SN, Yarlioglues M, Duran M, Ocek AH, Celik IE, et al. Procalcitonin as an Early Predictor of Contrast Induced Acute Kidney Injury in Patients With Acute Coronary Syndromes Who Underwent Percutaneous Coronary Intervention. Angiology. 2015;66(10):957-63.

Huang HL, Nie X, Cai B, Tang JT, He Y, et al. Procalcitonin levels predict acute kidney injury and prognosis in acute pancreatitis: a prospective study. PLoS One. 2013;8(12).

No national or foreign publication may partially or totally reproduce or translate Revista Colombiana de Nefrología articles or abstracts without prior written permission from the journal’s Editorial Board.




Download data is not yet available.