Role of procalcitonin and C-reactive protein in urinary tract infection diagnosis in adults

Bharath M. S., Ramesh S. Hiremath, Arini Basu


Background: Urinary tract infections are a common group of infections encountered in adults, and their treatment and prognosis are closely correlated with the location of infection. Clinical presentation and laboratory tests are insufficient to differentiate between upper urinary tract infection and lower urinary tract infection. So this study was conducted to explore a non-invasive diagnostic method for upper and lower urinary tract infection differentiation.

Methods: A case-control study included 2 groups of patients –30 cases and 30 controls. Cases further classified into 2 groups- a) Patients having upper urinary tract infection; b) Patients having lower urinary tract infection. Patients were subjected to following tests – complete hemogram, blood C-reactive protein levels, serum procalcitonin levels, urinalysis, ultrasound abdomen.

Results: Procalcitonin (PCT) and CRP values with upper urinary tract infection were significantly higher than those in with lower urinary tract infection. PCT has higher -sensitivity and a specificity than CRP.

Conclusions: Both procalcitonin and CRP can be used for upper and lower urinary tract infection differentiation, but Procalcitonin has higher sensitivity and specificity in predicting Upper urinary tract infection than CRP.


CRP, Procalcitonin, Urinary tract infection

Full Text:



Nina E, Tolkoff-Rubin, Ramzi S. Cortran, Robert H, Rubin. Urinary Tract Infection, Pylonephritis, and Reflux Nephropathy. In: Brenner Barry M, Rector, Floyd C, eds.Brenner and Rector’s The kidney.7th Ed. Philadelphia:Elsevier Saunders. 2:1515.

Gupta K, Trautner BW. Urinary tract infections, Pyelonephritis, and Prostatitis. In: Dennis L. Kasper, Dan L Longo, Stephen L. Hauser, Anthony S Fauci, J. Larry Jameson, Joseph Loscalzo, eds. Harrison’s principle of internal medicine.19th ed. New York,NY:Mcgraw-Hill; 2015:861.

Bagga A. Urinary tract infection, evaluation and treatment. Indian J Paediatrics. 2001;68:40-5.

Gulati S, Kher V. Urinary tract infection. Indian Paediatrics. 1996;33:122-6.

Harbarth S, Holeckova K, Froidevaux C, Pittet D, Ricou B, Grau GE, et al. Geneva Sepsis Network: diagnostic value of Precalcitonin, Interleukin-6, and Interlerkin-8 in critically ill patients admitted with suspected sepsis. Am J Respir Crit Care Med. 2001;164:396-402.

Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohuon C. High serum procalcitonin concentrations in patients with sepsis and infection.

Lancet. 1993;341:515-8.

Khan F, Malik MA, Afzal K, Khalid M. Renal biometric and serum C-Reactive Protein levels in the evaluation of urinary tract infections. Indian J Nephrology. 2004;14:10-4.

Gervaix A, Galetto-Lacour A, Geuron T. Usefulness of procalcitonin and C-reactive protein rapid tests for the management of children with urinary tract infection. Pediatr Infect Dis J. 2001;20:507-11.

Xu RY, Liu HW, Liu JL, Dong JH. Procalcitonin and C-reactive protein in urinary tract infection diagnosis. BMC Urology. 2014;14:45.

Agrawal P, Pandey A, Sompura S, Pursnani ML. Role of Blood C – Reactive Protein Levels in Upper Urinary Tract Infection and Lower Urinary Tract Infection in Adult Patients (>16 years). J Assoc Physicians India. 2013;61(7):462-3.

Meisner M, Tschaikowsky K, Schnabel S, Schmidt J, Alexander K, Schutter J. Procalcitonin-influence of temperature, storage, anticoagulation and arterial or venous asservation of blood samples on procalcitonin concentrations. Eur J Clin Chem Clin Biochem. 1997;35:597-601.