Diagnostic Value of the Systemic Immune-Inflammation Index in Newborns with Urinary Tract Infection

Abstract

Objective Aim of this study is to investigate the diagnostic role of the systemic immune-inflammation index (SII; neutrophil × platelet [PLT]/lymphocyte) in the prediction of renal involvement in newborns with urinary tract infection (UTI). Study Design We conducted a retrospective cohort study among 117 newborns with a gestational age greater than 35 weeks and hospitalized in the NICU. Laboratory values obtained from blood samples taken before the initiation of antibiotics were evaluated for renal function tests, complete blood count, and acute phase reactants. The ratios of platelet-to-lymphocyte (PLR), neutrophil-to-lymphocyte (NLR), and SII were calculated. The patients were divided into two main groups according to the presence of urinary tract pathology in ultrasonography (US): group 1, UTI with renal involvement (n = 43) and group 2, UTI without renal involvement (n = 74). Predictive values of different tests were compared. Results The mean white blood cell, PLT, mean PLT volume, and neutrophile counts were higher, while lymphocyte counts were significantly lower in group 1 than those of group 2. Interleukin 6 (IL-6; pg/mL; IL-6), C-reactive protein (CRP; mg/L), NLR, PLR, and SII values were also higher in group 1. Receiver operating characteristics curve showed that SII, CRP, IL-6, PLR, and NLR have a predictive ability to discriminate renal involvement from normal renal findings in newborns with UTI. The SII produced an area under curve of 0.75 (72% sensitivity and 60.8% specificity). To define renal involvement, the cut-off values of SII, CRP, IL-6, PLR, and NLR were 217, 3.06, 23, 65.5, and 0.60, respectively. Conclusion Our results showed that SII might be used as an additional parameter in the prediction of renal involvement in newborns with UTIs. Further studies are required. Key Points

Systemic Immune Inflammation Index as a Key Predictor of Dialysis in Pediatric Chronic Kidney Disease with the Use of Random Forest Classifier

“…Karakaya et al assessed the role of CBC-derived parameters in predicting acute pyelonephritis and showed that SII was among the best predictors of the development of acute pyelonephritis [28]. Likewise, according to Kocaaslan et al, SII might have a predictive value toward renal involvement in newborns with urinary tract infections [29].…”

“…The most recent studies have focused on the systemic immune inflammation index (SII), a newly defined ratio combining neutrophil, lymphocyte, and platelet counts. It is suggested as a prognostic indicator, comprehensively reflecting the inflammatory and immune status of patients with various renal diseases [25][26][27][28][29][30][31][32][33]. The data on SII in adults with CKD are limited, though elevated SII seems to have a predictive value for mortality risk among pre-dialysis and hemodialysis adult patients [30,31].…”