Abdelmalki Jihad, Seidel Laurence, Frippiat Frédéric, Lovinfosse Pierre, Jouret François
Division of Nephrology, ULiège Academic Hospital, Liège, Belgium.
Division of Biostatistics, ULiège Academic Hospital, Liège, Belgium.
Acta Clin Belg. 2025 Feb-Apr;80(1-2):25-28. doi: 10.1080/17843286.2025.2518059. Epub 2025 Jun 12.
The diagnosis of cyst infection in autosomal dominant polycystic kidney disease (ADPKD) is difficult. [18F]FDG PET/CT imaging is helpful, but early diagnosis remains challenging. Procalcitonin (PCT), a serum biomarker for bacterial infections, has not been evaluated in ADPKD-related cyst infections.
A retrospective review (between 2009 and 2023) identified all ADPKD patients who were (i) hospitalized (ii) with serum PCT measurements. Cyst infection was conventionally defined. Univariate and multivariate logistic regressions assessed the association between PCT and cyst infection risk.
The cohort included 104 patients (mean age of 65.5 ± 14.9 years; 49% post-kidney transplantation; 16.3% on chronic dialysis). Cyst infections occurred in 24 cases. [18F]FDG PET/CT was performed in 47 patients, detecting cyst infection in 17 cases and non-cystic inflammation in 11. In the whole cohort, CRP levels at admission reached 97.3 [42.8; 164] mg/L. Serum PCT level was measured within 72-h admission in 83/104 (79%) cases, and the median value reached 0.47 [0.18-2.04] µg/L. A significant correlation was observed between serums levels of PCT and creatinine at admission ( = 0.37, < 0.05). PCT > 0.59 µg/L significantly predicted cyst infection (OR = 6.30, = 0.0047). Antibiotics were administered ≥48 h before PCT measurement in 9/24 cases of cyst infection. PCT levels did not significantly differ between patients exposed to antibiotics (0.98 [0.43-2.19] µg/L) or not (1.42 [0.94-3.81] µg/L; = 0.39). Higher PCT was associated with cyst [18F]FDG uptake above the pathological threshold (OR = 2.01, = 0.0028).
PCT >0.59 µg/L within 72-h admission is a significant biomarker for cyst infection in ADPKD patients.
常染色体显性多囊肾病（ADPKD）中囊肿感染的诊断较为困难。[18F]FDG PET/CT成像有一定帮助，但早期诊断仍具有挑战性。降钙素原（PCT）作为细菌感染的血清生物标志物，尚未在ADPKD相关囊肿感染中进行评估。
一项回顾性研究（2009年至2023年）纳入了所有（i）住院且（ii）进行了血清PCT检测的ADPKD患者。囊肿感染采用传统定义。单因素和多因素逻辑回归分析评估PCT与囊肿感染风险之间的关联。
该队列包括104例患者（平均年龄65.5±14.9岁；49%为肾移植后患者；16.3%接受慢性透析）。24例发生囊肿感染。47例患者进行了[18F]FDG PET/CT检查，其中17例检测到囊肿感染，11例检测到非囊肿性炎症。在整个队列中，入院时CRP水平达到97.3[42.8；164]mg/L。83/104（79%）例患者在入院72小时内检测了血清PCT水平，中位数为0.47[0.18 - 2.04]μg/L。入院时血清PCT水平与肌酐水平之间存在显著相关性（r = 0.37，P < 0.05）。PCT>0.59μg/L显著预测囊肿感染（OR = 6.30，P = 0.0047）。9/24例囊肿感染患者在PCT检测前≥48小时使用了抗生素。使用抗生素患者与未使用抗生素患者的PCT水平无显著差异（0.98[0.43 - 2.19]μg/L对1.42[0.94 - 3.81]μg/L；P = 0.39）。较高的PCT与囊肿[18F]FDG摄取高于病理阈值相关（OR = 2.01，P = 0.0028）。
入院72小时内PCT>0.59μg/L是ADPKD患者囊肿感染的重要生物标志物。
