Abstract
Since the first report showing that the level of plasma presepsin [presepsin(p)] is significantly elevated in sepsis patients, presepsin(p) has been widely used as a diagnostic marker to determine the severity of sepsis and follow its course. However, owing to the renal excretion of presepsin(p), it seems that the evaluation of presepsin(p) level needs special attention in the presence of renal dysfunction. The effect of renal function on presepsin(p) level has not been well characterized. Herein, we have studied the level of presepsin(p) in renal dysfunction. (1) Out of 98 hemodialysis patients lacking any evidence of sepsis, 96 show a presepsin(p) level above the normal range, indicating that the presepsin(p) level in these patients is significantly higher than that in healthy controls (p < 0.001). (2) Furthermore, in the patients with chronic renal failure but without a history of hemodialysis, the level of presepsin(p) reversely correlates with the estimated glomerular filtration rate (eGFR) (R2 = 0.735). (3) On the other hand, it is found that hemodialysis significantly lowers presepsin(p) level (p < 0.001). Cumulatively, our findings indicate that it is critical to pay careful attention to renal function and hemodialysis in the evaluation of presepsin(p) level in sepsis patients.
