Procalcitonin values after dialysis is closely related to type of dialysis membrane

Background: Infections account for considerable morbidity and mortality in patients with chronic renal failure undergoinghemodialysis (HD). Diagnosis of infection in HD patients is challenging because the most used laboratory parameters maybe increased even in the absence of infection. In this setting, procalcitonin (PCT) could be useful for detection of systemicbacterial infections. Methods: We measured high sensitivity C Reactive Protein (hsCRP) and PCT serum levels beforeand immediately after dialysis in 44 HD patients (22 treated with high- and 22 with low-flux membranes), without historyof infections. Results: Patients on HD by high-flux membranes, but not by low-flux membranes, displayed mean PCTvalues significantly decreased after dialysis (high-flux: 0.50 vs. 0.26ng/mL, p0.005; low-flux: 0.41 vs. 0.42ng/mL,p0.863). HsCRP levels were unchanged. HsCRP correlated with PCT values both before and after HD only in patientson HD by low-flux membranes (r0.51 and 0.47 before and after HD respectively; p0.05). Conclusions: AlthoughPCT is considered a sensitive and specific diagnostic and prognostic marker of systemic bacterial infection, we suggest thatspecific reference ranges might be developed in patient with impaired renal function, also showing that and its clinicalusefulness might be limited in patients undergoing HD with high-flux membranes.