Procalcitonin as a Predictor of Acute Kidney Injury Following Cardiopulmonary Bypass

Background: Renal dysfunction following cardiac surgery involving cardiopulmonary bypass is associated with considerable morbidity and mortality. Procalcitonin has demonstrated effectiveness as a biomarker for guiding the initiation and duration of antibiotic therapy in patients admitted to intensive care units. This study aimed to assess procalcitonin as a predictor of acute kidney injury following cardiopulmonary bypass. Methods: This prospective observational study was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2021 to December 2023. A total of 40 patients who underwent elective cardiopulmonary bypass surgery were enrolled purposively. Data were analyzed using SPSS version 23.0. Results: Postoperatively, 37.5% of patients experienced acute kidney injury (AKI), with 86.7% classified as stage 1 and 13.3% as stage 2 AKI. A significant association was observed between the development of AKI and elevated postoperative procalcitonin levels (p < 0.05), indicating that higher procalcitonin levels correlate with an increased risk of AKI. Receiver Operating Characteristic (ROC) analysis of procalcitonin levels for AKI diagnosis revealed an Area Under the Curve (AUC) of 0.860 (95% CI: 0.725–0.995). A procalcitonin cutoff value of ≥4 ng/ml demonstrated 80% sensitivity and 92% specificity. Conclusion: The increased serum procalcitonin levels on 1st post-operative day can predict acute kidney injury in patients undergoing cardiac surgery with cardiopulmonary bypass.