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

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.