徳島大学 教育・研究者情報データベース(EDB)

1. (英) Miyoshi Masashi / (日) 三好 雅士 / (読) みよし まさし

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2. (英) Inoue Yusuke / (日) 井上 雄介 / (読) いのうえ ゆうすけ

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3. (英) Nishioka Mai

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4. 池亀 彰茂

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5. 中尾 隆之

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6. 岸 誠司

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7. 土井 俊夫

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8. 長井 幸二郎

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(英) Clinical evaluation of presepsin considering renal function.

(英) Presepsin, a glycoprotein produced during bacterial phagocytosis, is used as a sepsis marker for bacterial infections. However, presepsin levels are affected by renal function, and the evaluation criteria according to kidney function or in chronic kidney diseases remain controversial. Furthermore, presepsin may be increased by sample stirring, but no studies have evaluated this effect.In this study, we excluded the effect of stirring by standardizing the blood collection conditions, analyzed the influence of kidney function on presepsin concentrations, and recalculated the reference range based on the findings. EDTA-whole blood from 47 healthy subjects and 85 patients with chronic kidney disease was collected to measure presepsin by PATHFAST. Presepsin was found to be significantly correlated with the levels of creatinine (r = 0.834), eGFRcreat (r = 0.837), cystatin-C (r = 0.845), and eGFRcys (r = 0.879). Furthermore, in patients with CKD, presepsin levels stratified by eGFRcys showed a significant increase in the CKD G2 patient group and with advancing glomerular filtration rate stage. The following values were obtained: Normal: 97.6 ± 27.4 pg/mL, CKD G1: 100.2 ± 27.6 pg/mL, CKD G2: 129.7 ± 40.7 pg/mL, CKD G3: 208.1 ± 70.2 pg/mL, CKD G4: 320.2 ± 170.1 pg/mL, CKD G5: 712.8 ± 336.3 pg/mL. The reference range, calculated by a nonparametric method using 67 cases of healthy volunteers and patients with chronic kidney disease G1, was found to be 59-153 pg/mL, which was notably lower than the standard reference range currently used. Presepsin concentrations were positively correlated with a few biomarkers of renal function, indicating the necessity to consider the effect of renal function in patients with renal impairment. Using the recalculated reference range considering kidney function may improve the accuracy of evaluating presepsin for diagnosis of sepsis compared to the standard reference currently in use.

1. (英) Adult
2. (英) Aged
3. (英) Biomarkers
4. (英) Creatinine
5. (英) Cystatins
6. (英) Female
7. (英) Glomerular Filtration Rate
8. (英) Humans
9. (英) Kidney
10. (英) Lipopolysaccharide Receptors
11. (英) Male
12. (英) Middle Aged
13. (英) Peptide Fragments
14. (英) Renal Insufficiency, Chronic

1. (英) Article.ELocationID: 10.1371/journal.pone.0215791

2. (英) Article.PublicationTypeList.PublicationType: Journal Article

3. (英) CoiStatement: The authors have read the journal's policy and have the following conflicts: author Kojiro Nagai is a PLOS ONE Editional board member. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.