Authors Response: Potential Confounding Factors in the Use of the C-reactive Protein/Procalcitonin Ratio as a Prognostic Tool in Intensive Care Unit Patients with Sepsis

Role of C-reactive Protein/Procalcitonin Ratio as a Prognostic Tool in intensive care unit (ICU) Patients with Sepsis: A Prospective Observational Study".The valuable comments raised in the forwarded letter are highly appreciated.The results presented in Table 1, in the results section, indicate that the associated comorbidities encountered in the study patients did not show any statistically significant difference between the two studied groups -survivors and nonsurvivors.These comorbidities included: Diabetes mellitus (DM), hypertension (HTN), ischemic heart disease (IHD), and chronic kidney disease (CKD). 1 The ratio calculation was performed using blood samples collected on day 1 and day 3. 1 The administration of kidney replacement therapy (KRT) was not encountered in any case during the first 3 days of ICU stay.Although this entity (KRT) was not excluded, it was not available for inclusion in the analysis in our study.We agree with the authors that patients undergoing KRT may have procalcitonin clearance, which could affect the results of calculating C-reactive protein/procalcitonin (CRP/PCT) ratio.However, the investigation of this point may require further studies with repeated (serial) sampling for CRP/PCT ratio calculation over a longer period.So that, the need for KRT and its potential effect on the CRP/PCT ratio can be clearly illustrated.