Elevated urine levels of heparin-binding protein in children with urinary tract infection

Kjölvmark, Charlott; Åkesson, Per; Linder, Adam

doi:10.1007/s00467-012-2132-x

Cited by 26 publications

(21 citation statements)

References 23 publications

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“…Linder et al measured HBP in febrile adults presenting to the emergency department and showed that levels ≥ 15 ng/ml were a better indicator of severe sepsis or septic shock than procalcitonin [15]. Subsequent studies by the same group have demonstrated elevated levels of HBP in cerebrospinal fluid of patients with bacterial meningitis and the urine of children with urinary tract infections [22,23]. Our findings contrast with three previous studies of HBP conducted in ICU.…”

Section: Discussioncontrasting

confidence: 81%

Sepsis biomarkers in unselected patients on admission to intensive or high-dependency care

et al. 2013

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IntroductionAlthough many sepsis biomarkers have shown promise in selected patient groups, only C-reactive protein and procalcitonin (PCT) have entered clinical practice. The aim of this study was to evaluate three promising novel sepsis biomarkers in unselected patients at admission to intensive care. We assessed the performance of pancreatic stone protein (PSP), soluble CD25 (sCD25) and heparin binding protein (HBP) in distinguishing patients with sepsis from those with a non-infective systemic inflammatory response and the ability of these markers to indicate severity of illness.MethodsPlasma levels of the biomarkers, PCT and selected inflammatory cytokines were measured in samples taken from 219 patients during the first six hours of admission to intensive or high dependency care. Patients with a systemic inflammatory response were categorized as having sepsis or a non-infective aetiology, with or without markers of severity, using standard diagnostic criteria.ResultsBoth PSP and sCD25 performed well as biomarkers of sepsis irrespective of severity of illness. For both markers the area under the receiver operating curve (AUC) was greater than 0.9; PSP 0.927 (0.887 to 0.968) and sCD25 0.902 (0.854 to 0.949). Procalcitonin and IL6 also performed well as markers of sepsis whilst in this intensive care unit (ICU) population, HBP did not: PCT 0.840 (0.778 to 0.901), IL6 0.805 (0.739 to 0.870) and HBP 0.607 (0.519 to 0.694). Levels of both PSP and PCT reflected severity of illness and both markers performed well in differentiating patients with severe sepsis from severely ill patients with a non-infective systemic inflammatory response: AUCs 0.955 (0.909 to 1) and 0.837 (0.732 to 0.941) respectively. Although levels of sCD25 did not correlate with severity, the addition of sCD25 to either PCT or PSP in a multivariate model improved the diagnostic accuracy of either marker alone.ConclusionsPSP and sCD25 perform well as sepsis biomarkers in patients with suspected sepsis at the time of admission to intensive or high dependency care. These markers warrant further assessment of their prognostic value. Whereas previously published data indicate HBP has clinical utility in the emergency department, it did not perform well in an intensive-care population.

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Section: Discussioncontrasting

confidence: 81%

Sepsis biomarkers in unselected patients on admission to intensive or high-dependency care

et al. 2013

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“…Solid line represents the group mean concentrations and the dotted line from the y-axis is at 34 ng/mL of UHBP. [8]. Our study also showed that the UHBP levels in children with APN at 1 month after treatment were similar to those in the febrile non-APN children.…”

Section: Discussionsupporting

confidence: 81%

“…A possibility that UHBP might be secreted locally by activated neutrophils during APN is supported by these findings. First, levels of UHBP in the previous study by Kjolvmark et al and in this study were markedly elevated compared to serum HBP levels measured in patients with APN and urosepsis [3,8]. Second, in our study, levels of UHBP were positively correlated with the degree of pyuria.…”

Section: Discussioncontrasting

confidence: 45%

“…Based on the data reported in the previous study by Kjolmark et al [8] where 93 % of definite and probable UTI cases and 17 % of febrile non-UTI cases had UHBP concentrations >32 ng/mL, a sample size of 11 subjects in each group would detect this difference with 90 % power at a two-sided significant level of 5 %. Data analysis was conducted using Stata 13 (Statacorp, College Station, TX).…”

Section: Discussionmentioning

confidence: 99%

“…Various bacterial infections, including APN and urosepsis, stimulate the release of HBP into the systemic circulation [10,3]. A recent study showed that urine HBP (UHBP) provided better sensitivity and specificity compared to urine dipstick analysis in children with upper or lower urinary tract infection (UTI) [8]. As some reports demonstrated that urine microscopy had better accuracy than dipstick analysis in young children [14,12], the diagnostic performance of UHBP in comparison to urine microscopy is of paramount interest and has yet to be determined.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of urine heparin binding protein for pediatric acute pyelonephritis

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Kerr³

et al. 2014

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The diagnosis of febrile urinary tract infection in children may be facilitated by urinary biomarkers

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Elevated urine levels of heparin-binding protein in children with urinary tract infection

Cited by 26 publications

References 23 publications

Sepsis biomarkers in unselected patients on admission to intensive or high-dependency care

Sepsis biomarkers in unselected patients on admission to intensive or high-dependency care

Diagnostic accuracy of urine heparin binding protein for pediatric acute pyelonephritis

The diagnosis of febrile urinary tract infection in children may be facilitated by urinary biomarkers

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