Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan; Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan; Graduate School of Public Health, Teikyo University, Tokyo, Japan.
Clin Chim Acta. 2020 Jan;500:1-9. doi: 10.1016/j.cca.2019.09.012. Epub 2019 Oct 5.
Presepsin is a useful biomarker to diagnose sepsis. However, the correlation between plasma presepsin concentrations and kidney function in the elderly with chronic kidney disease (CKD) remains to be elucidated. We determined whether plasma presepsin concentrations were influenced by kidney function decline in the elderly.
One hundred seventy outpatients with CKD aged ≥65 y were enrolled. Plasma presepsin concentrations were measured using immunoassay analysis. The relationship between plasma presepsin concentration and kidney function was assessed.
The median age of patients of this cohort was 778 (72-85) y and the mean estimated glomerular filtration rate was 51.8 ± 28.1 ml/min/1.73 m. Plasma presepsin concentrations in those with CKD G4-G5 (362 pg/ml [273-553]) were significantly higher than in those with CKD G1-G2 (111 pg/ml [91-113]) and CKD G3 (145 pg/ml [124-205]) (p < 0.001, p < 0.001, respectively). A high correlation between plasma presepsin concentrations and kidney function was observed (R = 0.733, p < 0.001). Even after adjusting for confounders, plasma presepsin concentrations were independently associated with kidney function.
Increases in plasma presepsin concentrations were exponentially correlated to kidney function decline in the elderly with CKD.
降钙素原（Presepsin）是诊断脓毒症的有用生物标志物。然而，老年人慢性肾脏病（CKD）患者的血浆降钙素原浓度与肾功能之间的关系仍有待阐明。我们旨在确定血浆降钙素原浓度是否受老年人肾功能下降的影响。
本研究纳入了 170 名年龄≥65 岁的 CKD 门诊患者。采用免疫分析法测定血浆降钙素原浓度。评估血浆降钙素原浓度与肾功能之间的关系。
该队列患者的中位年龄为 778（72-85）岁，平均估算肾小球滤过率为 51.8±28.1ml/min/1.73m。CKD G4-G5 患者的血浆降钙素原浓度（362pg/ml[273-553]）明显高于 CKD G1-G2 患者（111pg/ml[91-113]）和 CKD G3 患者（145pg/ml[124-205]）（p<0.001，p<0.001）。血浆降钙素原浓度与肾功能之间存在高度相关性（R=0.733，p<0.001）。即使在校正了混杂因素后，血浆降钙素原浓度仍与肾功能独立相关。
老年人 CKD 患者的血浆降钙素原浓度随肾功能下降呈指数增加。
