Changes of Early Sepsis Biomarker Presepsin Level during Hemodialysis: Influence of β2-Microglobulin Clearance of Dialysis Membrane: A Preliminary Study

Background: Although presepsin (P-SEP) is an early sepsis biomarker, sepsis is often suspected after starting hemodialysis (HD). To enhance the utility of P-SEP, we investigatedwhether pre-HD P-SEP levels could be predicted using the P-SEP levels from blood samples collected after starting HD.

Methods: We observed P-SEP level changes due to HD and dialyzer passage in HD patients using a dialysis membrane with a β2-microglobulin (β2-MG) clearance of either ≥50 mL/ min (high-flux) or < 30 mL/min (intermediate-flux). We calculated the removal ratios for the elimination of P-SEP or the predicted pre-HD P-SEP levels based on the correction of hemoconcentration.