Abstract

Purpose: Acute pyelonephritis (APN) is accompanied by bacteremia and has a high incidence of mortality. Currently, there is a limited number of rapid diagnostic tests that can predict the severity of infection and suitable treatments for patients with APN. Herein, we determined whether serum procalcitonin (PCT) is a useful predictive and early cognitive marker according to the severity of APN.
Materials and Methods: Patients were divided into four groups according to the severity of infection: (1) No systemic inflammatory response syndrome (SIRS), (2) SIRS, (3) severe sepsis, and (4) septic shock. We measured the inflammatory biomarkers−PCT, C-reactive protein (CRP), and erythrocyte sedimentation rate. One way ANOVA analysis was performed between the measured infection markers and the severity of infection. The p-value of less than 0.05 was considered by the post-hoc multiple comparisons.
Results: A total of 381 patients with APN were divided into four groups: (1) no SIRS (n=126, 33.1%), (2) SIRS (n=185, 48.6%), (3) severe sepsis (n=47, 12.3%), and (4) septic shock (n=23, 6.0%). PCT (p<0.001) and CRP (p=0.002) showed a significant difference among the group. Greater severity of infection grade was associated with higher PCT and CRP values. According to the multivariate analysis, there was a statistically significant difference of PCT among all grades.
Conclusions: The serum PCT was a helpful marker for predicting severity of APN. Moreover, be a useful predictor of sepsis and septic shock.

• Keywords: Procalcitonin; C-reactive protein; Pyelonephritis