Abstract

Purpose
Recently, multiple studies have reported presepsin as a useful inflammatory biomarker for early sepsis diagnosis in patients with urinary tract infections (UTIs). Nonetheless, few studies have evaluated the efficacy of presepsin in urosepsis associated with ureteral calculi. We retrospectively investigated the efficacy of presepsin for early urosepsis diagnosis associated with ureteral calculi. Materials and Methods: Between May 2021 and July 2023, 64 patients with UTI associated with ureteral calculi were included. Sepsis was defined as a Sequential Organ Failure Assessment (SOFA) score increase of ≥2 points. Patients were divided into 2 groups, with (n=38) and without (n=26) sepsis, and we assessed clinical characteristics (age, sex, and past medical history), laboratory data, and stone characteristics. Additionally, we evaluated predictive factors for urosepsis associated with ureteral calculi and compared these factors with inflammatory biomarkers.
Results
The proportion of females in the sepsis and nonsepsis groups was 89.5% (n=34) and 61.5% (n=16), respectively. In univariable analysis, low albumin level, low platelet count, and presepsin and procalcitonin (PCT) levels correlated with sepsis (p<0.05). In univariable logistic regression analysis, quick SOFA (odds ratio [OR], 2.071; p=0.033), C-reactive protein (CRP; OR, 1.08; p=0.01), PCT (OR, 1.025; p=0.008), and presepsin (OR, 1.354; p=0.001) were significantly associated with sepsis. In multivariate logistic regression analysis, presepsin (OR, 1.321; p=0.003) was significantly associated with sepsis. In receiver operating characteristic curve analysis of inflammatory markers, the areas under the curve for CRP, PCT, and presepsin were 0.704, 0.777, and 0.814, respectively.
Conclusions
Elevated presepsin levels may help predict sepsis occurrence in patients with UTI associated with ureteral calculi, thereby supporting timely and appropriate intervention.

• Keywords: Sepsis, Percutaneous nephrostomy, Urinary tract infections, Ureteral calculi, Biomarkers