Evaluation of Serum Presepsin in the Diagnosis and the Prognosis of Cirrhotic Patients with Ascites

Background: Liver cirrhosis is a serious problem associated with spontaneous bacterial peritonitis and renal dysfunction. Presepsin is a soluble Cluster of Differentiation 14 (CD14) Protein subtype that has been implicated as an important biomarker in many diseases.

Objective: To assess the clinical value of presepsin as a diagnostic and prognostic marker for spontaneous bacterial peritonitis in cirrhotic patients.

Patients and Methods: This cross-sectional study was carried out on 60 cirrhotic patients with ascites. The data were collected from Internal Medicine Hospital Inward and ICUs of Internal Medicine.

Results: Serum presepesin had a significant negative correlation with serum albumin (rs = -0.350, p = 0.006) and a significant positive correlation with platelet count (rs =0.547, p < 0.001). In the Spontaneous bacterial peritonitis (SBP) group, presepesin correlated significantly positively with total leukocytic count (rs =0.547, p < 0.001). The level of serum presepsin significantly increased with the group suffering from Hepatorenal syndrome (HRS) than the ascites group after adjusting for age, C-reactive Protein (CRP) level, and total leukocytic count. Similarly, the level of serum presepsin significantly increased with the SBP group than the ascites group after adjusting for age, CRP level, and total leukocytic count.

Conclusion: presepsin is a promising biomarker in the diagnosis of bacterial infections and hepatorenal syndrome in cirrhosis. However, the diagnostic and prognostic value of presepsin needs further studies.