Predictive value of urinary and serum biomarkers in young children with febrile urinary tract infections

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• 作者：Hyung Eun Yim ; Hyungshin Yim ; Eun Soo Bae ; Sang Uk Woo…
• 关键词：Acute kidney injury ; Bacterial infections ; Biomarkers ; Child ; Pyelonephritis
• 刊名：Pediatric Nephrology
• 出版年：2014
• 出版时间：November 2014
• 年：2014
• 卷：29
• 期：11
• 页码：2181-2189
• 全文大小：485 KB
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• 作者单位：Hyung Eun Yim (1) (2)
  Hyungshin Yim (3)
  Eun Soo Bae (1)
  Sang Uk Woo (3)
  Kee Hwan Yoo (1)
  
  1. Department of Pediatrics, College of Medicine, Korea University, Seoul, South Korea
  2. Department of Pediatrics, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan, Gyeonggi-do, 425-707, Korea
  3. Department of Pharmacy, College of Pharmacy, Institute of Pharmaceutical Science and Technology, Hanyang University, Ansan, Gyeonggi-do, South Korea
  
• ISSN：1432-198X

文摘

Background Early predictive biomarkers for the diagnosis and management of febrile urinary tract infections (UTIs) can be valuable diagnostic tools in children. Methods The study cohort comprised 73 pediatric patients with febrile UTIs [46 with acute pyelonephritis (APN) and 27 with lower UTIs] and 56 healthy children. Urine neutrophil gelatinase-associated lipocalin (uNGAL) and kidney injury molecule-1 (uKIM-1) levels and serum cystatin C (sCysC) levels were measured. Results The uNGAL/creatinine (Cr) and uKIM-1/Cr levels were higher in the UTI group than in the controls (P--.05). uNGAL/Cr and sCysC levels were higher in patients with APN than in those with lower UTIs (P--.05). uNGAL/Cr levels in both the APN and UTI groups decreased following the administration of antibiotics compared to those before treatment (P--.05). The uNGAL/Cr level was correlated with serum levels of white blood cells, C-reactive protein, CysC and with uKIM-1/Cr (P--.05). uKIM-1/Cr was also correlated with sCysC (P--.05). Receiver operating curve analyses showed good diagnostic profiles of uNGAL/Cr and uKIM-1/Cr for identifying UTIs [area under the curve (AUC) 0.9 and 0.66, respectively) and of uNGAL/Cr and sCysC for predicting APN (AUC 0.78 and 0.72, respectively). Conclusions Our results suggest that uNGAL, uKIM-1 and sCysC levels may be useful for predicting and managing febrile UTIs in children.