Procalcitonin and Pancreatic Stone Protein as markers of infection in children with Chronic Renal Failure in Zagazig University Hospitals Mohammed Atef Mahmoud El Attar , Seham Fathy Azab, Norhan Abdallah Sabbah , and Ezzat Kamel Amin Zagazig University Medical Journal Accepted Manuscript, Available Online from 18 September 2020 Background: Infectious complications in children with chronic renal disease (CKD) are a major cause of increased morbidity and mortality rates among these children. Aim of the work: This study aimed to determine the diagnostic value of Procalcitonin (PCT) and Pancreatic Stone Protein (PSP) as markers of infection in children with chronic renal failure and to decrease morbidity and mortality rates in these children. Patients and Methods: This case control study was conducted on 36 patients diagnosed with Chronic Renal Failure and admitted at Nephrology Pediatric Unit, Children’s Hospital, Zagazig University during the period from October 2018 to February 2019. They were divided into 2 groups, the first group (case group) included 18 children with CKD diagnosed with infectious complications, the second group included (control group) 18 children with CKD who didn't develop any infectious complications .The serum expression of PCT and PSP was measured. Pearson correlation analysis was conducted to correlate PCT & PSP with each other and with CRP, temperature, HR, pus cells and blood culture. ROC analysis was used to test the value of PCT, PSP and CRP in early diagnosis of infection in Children with chronic renal failure. Results: The serum levels of PCT and PSP in case group were higher than in control group (P<0.01). Serum PCT concentrations showed a significantly positive correlation with PSP levels (P<0.001). ROC analysis showed that the area under curve (AUC) values of PCT, PSP and CRP were 0.944 (95% CI, 866–1.000), 0.870 (95% CI, 0.757– 0.984) and 0.931 (95% CI, 0.729 –0.859) respectively and suggested cutoff levels were >0.62 ng/ml for PCT, >22.8 ng/ml for PSP and >6.5mg/L for CRP with sensitivity 88.9%, 81.8% and 83.3% respectively and specificity 95.6%, 72.2% and 94.4% respectively. Conclusion: Serum levels of PCT and PSP are promising biomarkers of early detection of infectious complications in Children with Chronic renal failure.