Is mid-regional pro-atrial natriuretic peptide (MRproANP) an accurate marker of bacteremia in pyelonephritis?

Biomarkers. 2011 Jun;16(4):355-63. doi: 10.3109/1354750X.2011.576769.

Abstract

Introduction: Mid-regional pro-atrial natriuretic peptide (MRproANP) increases during systemic infections and could possibly correlate with bacteremia.

Methods: We determined the characteristics of MRproANP for accuracy to detect positive blood culture.

Results: Bacteremia was positive in 58 (15%) of 347 patients. MRproANP levels increased in patients with bacteremia (98.4 pmol/L [interquartile range (IQR) 68.2-153.1] vs. 66.4 pmol/L [IQR 51.0-90.3], p <0.01). Performance of MRproANP to predict bacteremia [AUC = 0.69, 95%CI: 0.61-0.77] was equivalent to C-reactive protein (0.66 [95%CI: 0.59-0.74], p = 0.53) but less accurate than procalcitonin (0.78 [95%CI: 0.72-0.84], p <0.001).

Conclusion: Although MRproANP increased in bacteremic patients with acute pyelonephritis, results of likelihood ratios discarded its use at bedside to predict bacteremia.

Publication types

  • Comparative Study
  • Evaluation Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Atrial Natriuretic Factor / blood*
  • Bacteremia / diagnosis
  • Bacteremia / etiology
  • Bacteremia / pathology*
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Calcitonin / blood
  • Calcitonin Gene-Related Peptide
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests*
  • Protein Precursors / blood
  • Pyelonephritis / complications
  • Pyelonephritis / microbiology*

Substances

  • Biomarkers
  • CALCA protein, human
  • Protein Precursors
  • Atrial Natriuretic Factor
  • Calcitonin
  • C-Reactive Protein
  • Calcitonin Gene-Related Peptide