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Presepsin (sCD14-ST) in emergency department: the need for adapted threshold values?
Camille Chenevier-Gobeaux1, Eloise Trabattoni, Marie Roelens
1Groupe Hospitalier Cochin-Broca-Hôtel Dieu, APHP, Department of Biochemistry, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France.
Insights
Presepsin levels increase with age and kidney dysfunction. Healthcare providers should consider these factors when interpreting presepsin values, especially in elderly patients or those with impaired renal function.
Area of Science:
- Biomarker research
- Clinical diagnostics
- Geriatric medicine
Background:
- Presepsin is a biomarker indicating infection and its severity.
- Its behavior in non-infectious conditions, particularly in relation to age and renal function, requires further investigation.
Purpose of the Study:
- To evaluate circulating presepsin levels in patients without acute infections.
- To determine the influence of age and kidney dysfunction on presepsin concentrations.
Main Methods:
- Recruitment of 144 emergency department patients without acute conditions and 54 healthy controls.
- Measurement of plasma presepsin concentrations using the PATHFAST point-of-care analyzer.
- Statistical analysis to compare presepsin levels across different age groups and in relation to kidney function.
Main Results:
- The 95th percentile of presepsin in the emergency department population was 750 ng/L.
- Presepsin levels were significantly higher in patients aged ≥70 years and those with kidney dysfunction.
- Aging was identified as an independent predictor of elevated presepsin.
Conclusions:
- Presepsin concentrations are influenced by aging and kidney dysfunction.
- Current presepsin interpretation thresholds may need adjustment for elderly individuals and patients with renal impairment.
- Development of population-specific thresholds for presepsin is recommended.
Abstract:
Presepsin is elevated in patients developing infections and increases in a severity-dependent manner. We aimed to evaluate circulating values of this new biomarker in a population free of any acute infectious disorder. We recruited 144 consecutive patients presenting at the emergency department (ED) without acute infection or acute/unstable disorder, and 54 healthy participants. Presepsin plasmatic concentrations were measured on the PATHFAST point-of-care analyzer. The 95th percentile of presepsin values in the ED population is 750ng/L. Presepsin was significantly increased in patients aged ≥70years vs. younger patients (470 [380-601] ng/L vs. 300 [201-457] ng/L, p<0.001). Prevalence of elevated presepsin values was increased in patients in comparison to controls (80% vs.13%, p<0.001), and in patients aged ≥70years in comparison to younger patients (87% vs. 47%, p<0.001). Presepsin concentrations were significantly increased in patients with kidney dysfunction. Aging was an independent predictor of an elevated presepsin value. In conclusion, presepsin concentrations increase with age and kidney dysfunction. Therefore interpretation of presepsin concentrations might be altered in the elderly or in patients with impaired renal function. Adapted thresholds are needed for specific populations.
