BACKGROUND: The identification of acute pyelonephritis (APN) is still a challenge. METHODS: 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. RESULTS: 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). CONCLUSION: Plasma NGAL can be a sensitive predictor for identifying APN and monitoring the treatment response of pediatric UTI.
BACKGROUND: The identification of acute pyelonephritis (APN) is still a challenge. METHODS: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. RESULTS: 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). CONCLUSION: Plasma NGAL can be a sensitive predictor for identifying APN and monitoring the treatment response of pediatric UTI.
Authors: Giorgina B Piccoli; V Consiglio; L Colla; P Mesiano; A Magnano; M Burdese; C Marcuccio; E Mezza; V Veglio; G Piccoli Journal: Int J Antimicrob Agents Date: 2006-07-18 Impact factor: 5.283
Authors: Catherine L Dent; Qing Ma; Sudha Dastrala; Michael Bennett; Mark M Mitsnefes; Jonathan Barasch; Prasad Devarajan Journal: Crit Care Date: 2007 Impact factor: 9.097
Authors: Nader Shaikh; Judith M Martin; Alejandro Hoberman; Megan Skae; Linette Milkovich; Andrew Nowalk; Christi McElheny; Robert W Hickey; Diana Kearney; Massoud Majd; Eglal Shalaby-Rana; George Tseng; John F Alcorn; Jay Kolls; Marcia Kurs-Lasky; Zhiguang Huo; William Horne; Greg Lockhart; Hans Pohl; Timothy R Shope Journal: J Pediatr Date: 2019-03-21 Impact factor: 4.406