Biomarkers and risk factors for sepsis in stage 5 chronic kidney disease: a retrospective case–control study
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To assess the predictive value of procalcitonin (PCT) in the risk of sepsis in patients with stage 5 chronic kidney disease (CKD).
A total of 373 inpatients with stage 5 CKD were retrospectively analyzed. The patients were divided into non-infection group, local infection group, and sepsis group. The clinical characteristics and inflammatory parameters including PCT, C-reactive protein (CRP), white blood cell count (WBC), and neutrophil percentage (NEU%) were compared and the receiver operating characteristic (ROC) curves to predict sepsis were plotted. Related risk factors of sepsis were analyzed by logistic regression analysis.
(1) The hemodialysis ratio of sepsis group was the highest at 92.3%. PCT, CRP, and NEU% were significantly different among the three subgroups (P < 0.05 for all). Total cholesterol and low density lipoprotein (LDL) levels in sepsis group were significantly lower than that in local infection group (P < 0.05 for both). (2) CRP and WBC were unable to predict sepsis (P > 0.05 for all), while PCT and NEU% could predict sepsis with areas under the curve (AUC) of 0.838 and 0.691, respectively (P < 0.05 for all). (3) Multivariate logistic regression analysis showed that PCT > 1.650 ng/mL was a risk factor (OR = 6.926, P = 0.002) while LDL was probably a protective factor (OR = 0.336, P = 0.040) of sepsis in patients with stage 5 CKD.
At stage 5 CKD, the predictive value of PCT for sepsis is best among inflammatory markers, and PCT and LDL levels are independent factors of sepsis.
KeywordsChronic kidney disease Procalcitonin Low density lipoprotein Sepsis Risk factors
Chronic kidney disease
White blood cell count
Receiver operating characteristic
Areas under the curve
End-stage renal diseases
Renal replacement therapy
Systemic inflammatory response syndrome
Glomerular filtration rate
Estimated glomerular filtration rate
Blood urea nitrogen
High density lipoprotein
Low density lipoprotein
Coronary atherosclerotic disease
YS and XS conceived of the study, and drafted the manuscript. LJ carried out the Lab testing. XS participated in the design of the study and performed the statistical analysis.
This work was supported by Natural Science Foundation of China (No. 81771798).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
The study has been approved by the Ethics Committee of Soochow University.
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