Use of Procalcitonin for Detection of Bacterial Infection in Patients With Chronic Kidney Disease: A Retrospective Cohort Study

Procalcitonin (PCT) interpretation in chronic kidney disease (CKD) patients is challenging, as levels may rise even without infections. This study aimed to evaluate PCT dynamics during bacterial infections across CKD stages and assess its diagnostic utility. In this retrospective, single-center study, 505 hospitalized patients (293 with CKD and 212 controls) with confirmed bacterial infections were included. Patients were classified according to KDIGO CKD stages. PCT levels were measured at 24, 48, 72, 96 h, and at discharge. PCT levels were significantly higher in CKD patients compared to those without CKD at all time points. Levels tended to increase or remain elevated with advancing CKD stage, except in stage 5. A significant decline in PCT was observed at the 96th hour, with a delayed decrease in advanced CKD. PCT is a valuable biomarker for bacterial infections in CKD; however, stage-specific thresholds may be necessary to avoid misdiagnosis and improve clinical utility.