Assessment of procalcitonin and other inflammatory markers in peritoneal dialysis-related peritonitis*

Authors: REYHAN ÖZTÜRK, GÜL R. YILMAZ, CEMAL BULUT, HÜLYA PARPUCU, SAMİ KINIKLI, MURAT DURANAY, ALİ PEKCAN DEMİRÖZ

Abstract: It is demonstrated that in end-stage renal failure without an infectious pathology conventional laboratory parameters such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) or other acute-phase proteins increase non-specifically. We aimed to evaluate procalcitonin (PCT) and other inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in patients with continuous ambulatory peritoneal dialysis (CAPD)-related peritonitis. Materials and methods: A case-control study was conducted in a 600-bed tertiary hospital. Fifty patients with CAPD-related peritonitis constituting the study group and 50 CAPD patients without infection as the control group were included in the study between February 2006 and July 2006. Baseline serum WBC count, PCT, ESR, and CRP levels were determined in all patients. Results: Fifty-six peritonitis episodes were detected in 50 patients. The mean ESR and CRP levels were significantly higher in the study group (P < 0.001). PCT levels were >0.5 ng/mL in 21 of the 50 patients (42%) in the study group and 8 of the 50 patients (16%) in the control group. The positive predictive value was 100% for CRP levels higher than 5 mg/dL and PCT levels higher than 2 ng/mL. The sensitivities were calculated as 40% and 14% by the same cut-off levels for CRP and PCT, respectively. Conclusion: Serum CRP level is a significant and valuable parameter for detecting inflammation, and determining a new cut-off point for CRP will increase its usefulness in patients with CAPD-related peritonitis. The sensitivity and specificity of PCT were not superior to CRP in peritoneal dialysis-related peritonitis.

Keywords: Procalcitonin, C-reactive protein, peritonitis, inflammation markers

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