The Correlation And Predictive Value Of Procalcitonin And SOFA In Sepsis Patients With Acute Kidney Injury

Objective: Procalcitonin(PCT)and sepsis-related organ failure assessment(SOFA)are not only effective diagnostic indicators of sepsis,but also closely reted to Acute kidney injury(AKI).this study aims to explore the correlation and predictive value of serum PCT and SOFA in sepsis patients with AKI.Methods: Patients with sepsis were enrolled who admitted to the intensive care unit of the first affiliated hospital,Guangxi medical university from April1 st 2016 to July 31 st 2018 in this retrospective analysis study.Serum PCT,SOFA and the related clinical data were collected.Various indicators were analyzed to realize the correction in sepsis patients with AKI by univariate statistical analysis,and the risk factors of sepsis patients with AKI were analyzed by binary stepwise logistic regression.The receiver operating characteristic curve(ROC)was used to evaluate the predictive value of PCT and SOFA alone and in combination for AKI in patients with sepsis.Results: A total of 192 patients with sepsis were enrolled in our study,including 90 patients(46.88%)with AKI.Compared with non-AKI group,the level of serum PCT and SOFA were significantly increased in AKI group[PCT(ng/mL): 2.78(0.63,20.83)vs 0.65(0.25,3.37),P <0.001,SOFA(score):8.00(6.00,10.25)vs 6.00(4.00,8.00),P <0.001].Serum PCT lever was higher in the Multiple Organ Dysfunction Syndrome(MODS)group than in the non-MODS group(P <0.05).In the binary logistic regression,we can found that serum PCT(OR =1.038,95%CI 1.001-1.076,P =0.043)and SOFA(OR =1.130,95%CI 1.009-1.266,P =0.034)were independent risk factors of sepsis patients with AKI after adjusting gender,cerebrovascular disease,MODS,infection sources,lactate(Lac),PCT,white blood cell(WBC),uric acid(UA),brain natriuretic peptide(BNP)and SOFA,which prompted serum PCT and SOFA were associated with the occurrence of sepsis AKI The ROC curve showed that the lever of PCT and SOFA were significantly predicted sepsis patients with AKI which area under receiver operating characteristic curve(AUROC)was0.697(95%CI 0.623-0.771,P <0.001)and 0.660(95%CI 0.582-0.738,P <0.001),respectively.When the cut-off value of serum PCT and SOFA respectively was0.791 ng/mL and 8.50 score,the sensitivity respectively was 74.2% and 47.8%,the specificity respectively was 56.9% and 80.4%.While united with PCT and SOFA by SPSS,the AUROC was 0.711(95%CI 0.637-0.785,P <0.001),the sensitivity was 67.4%,the specificity was 67.6%.When both were used to predict sepsis patients with AKI in parallel diagnosis,the sensitivity was 84.3%.and in series diagnosis,the specificity was 85.3%.Conclusions: The level of serum PCT and SOFA were higher in AKI with sepsis than non-AKI,and both were independent risk factors for the occurrence of sepsis patients with AKI,suggesting than both were closely related to the occurrence of AKI in patients with sepsis.When in parallel diagnosis of PCT and SOFA,it could improve the predictive efficacy of sepsis complicated with AKI.