Plasma neutrophil gelatinase-associated lipocalin predicts acute pyelonephritis in children with urinary tract infections

Pediatric Research
Ji Hyun SimKee Hwan Yoo

Abstract

The identification of acute pyelonephritis (APN) is still a challenge. Patients admitted for their first urinary tract infection (UTI) were enrolled. Plasma neutrophil gelatinase-associated lipocalin (NGAL) levels were measured at admittance and after treatment. Laboratory, clinical, and imaging results were compared between children with and without APN. A total of 123 patients were enrolled (53 APN and 70 lower UTI). After adjusting for age and gender, plasma NGAL levels were higher in the APN group than in the lower UTI group (233 (129-496) ng/ml vs. 71 (50.8-110) ng/ml, P < 0.001). NGAL levels were correlated with the serum levels of leukocytes, C-reactive protein, and creatinine, as well as fever duration (P < 0.05). Multivariable analysis revealed that log-transformed plasma NGAL was an independent predictor of APN (P < 0.05). Receiver operating curve analysis showed a good diagnostic profile of NGAL for identifying APN (area under the curve 0.864) with a best cut-off value of 102.5 ng/ml. The NGAL levels in both two groups decreased after treatment compared to levels before treatment (P < 0.001). Plasma NGAL can be a sensitive predictor for identifying APN and monitoring the treatment response of pediatric UTI.

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Citations

Jun 9, 2015·Clinical Chemistry and Laboratory Medicine : CCLM·Jadranka ArambašićVatroslav Šerić
Oct 17, 2016·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Byung Kwan KimKee Hwan Yoo
Oct 28, 2016·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Catherine S Forster, Prasad Devarajan
Sep 11, 2020·The Cochrane Database of Systematic Reviews·Kai J ShaikhNader Shaikh
Dec 29, 2018·Recent Patents on Inflammation & Allergy Drug Discovery·Alexander K C LeungKam L Hon
Jan 4, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Kai ShaikhNader Shaikh
Mar 25, 2019·The Journal of Pediatrics·Nader ShaikhTimothy R Shope

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