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Elevation of procalcitonin in chronic dialysed patients


In some chronic dialysed patients, without signs of infection, increased values of procalcitonin (PCT) are found. The aim of our work was to determine the relations of PCT with other markers of inflammation.


Heparinized plasma of 35 chronically dialysed patients without infection were analysed before and after 4 hours of dialysis. Parameters were daily diuresis, diabetes mellitus (yes/no), secondary hyperparathyroidism (yes/no), IL-10, IL-12 (flow cytometry), calprotectin (spectrophotometry), PCT (ELFA; Brahms), C-reactive protein (CRP) (turbidimetry; Modular). Statistics involved the Spearman correlation coefficient and the nonparametric Mann–Whitney test.


The PCT level was above 0.5 μg/l in seven patients and the maximal value was 4.9. The median, lower and upper quartiles were calculated before and after dialysis. During dialysis the values of PCT were not statistically different; similarly the value of IL-10, IL-12, CRP and calprotectin. Calprotectin was significantly elevated in hemodialysed patients in comparison with blood donors (P < 0.001). Reference ranges: IL-10, 10–35%; IL-12, 20–40%; calprotectin, 0–12 μg/ml; CRP, <7 mg/l; PCT, <0.5 μg/l. See Table 1

Table 1 Markers of inflammation: statistical parameters


No significant change of IL-10, IL-12 and of calprotectin during dialysis indicates no activation of monocytes, nor of polymorphonuclear cells. An elevated level of calprotectin confirms chronic persisting inflammation. There was no correlation between PCT and all other markers of inflammation. Elevation of PCT in chronic dialysed patients is not caused by infection systemic inflammation. We also found no correlation of elevation of PCT with diuresis, diabetes mellitus and secondary hyperparathyroidism.

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Brodska, H., Malickova, K., Kazda, A. et al. Elevation of procalcitonin in chronic dialysed patients. Crit Care 12 (Suppl 2), P179 (2008).

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