Abstract: Objective  To explore the diagnostic value of high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), and white blood cell count (WBC) in maintenance hemodialysis (MHD) patients combined with infection.  Methods  The MHD patients hospitalized in the Blood Purification Center of Honghe First People's Hospital from January 1, 2022 to December 31, 2023 were enrolled in this study. They were divided into infected group and non-infected group. Serum hs-CRP, PCT and WBC count were measured and compared between the two groups. The efficacy of the three indexes for the diagnosis of infection in MHD patients was evaluated by receiver operator characteristic (ROC) curve.   Results  A total of 136 patients were included in this study (70 patients in infected group, and 66 patients in non-infected group). Hospitalization day (t=-6.706, P<0.001) and hospitalization expenses (t=-5.592, P<0.001) were higher in the infected group than in the non-infected group. Serum hs-CRP (t=-7.021, P<0.001), PCT (t=-6.063, P<0.001) and WBC (t=-3.218, P=0.001) were higher in the infected group than in the non-infected group. The diagnostic value of hs-CRP was higher than that of PCT and WBC for the infection in MHD patients. If the cutoff value of hs-CRP was set at 16.25 mg/L, the area under the curve (AUC) corresponding to the maximum entry index was 0.849, with the sensitivity of 83.33%, and the specificity of 75.71%. Serum hs-CRP combined with PCT had the best diagnostic efficacy, with the AUC corresponding to the maximum boarding index of 0.882, the sensitivity of 89.39%, and the specificity of 74.29%; serum hs-CRP combined with PCT and WBC had a better diagnostic efficacy, with the AUC of 0.878, the sensitivity of  83.33%, and the specificity of 80.00%.  Conclusion   Combined use of hs-CRP, PCT and WBC have a better diagnostic value, and can be used as a clinical reference to initiate antimicrobial treatment in MHD patients complicated with infection.

Key words: Maintenance hemodialysis, Infection indicator, Diagnostic value, Infection, High-sensitivity C-reactive protein