Procalcitonin is a Predictor for High-Grade Vesicoureteral Reflux in Children: Meta-Analysis of Individual Patient Data

Leroy, Sandrine; Romanello, Carla; Galetto-Lacour, Annick; Bouissou, F; Fernández-López, Anna; Smolkin, Vladislav; Gurgoz, Metin K.; Bressan, Silvia; Karavanaki, Kyriaki; Tuerlinckx, David; Leblond, Pierre; Pecile, Paolo; Coulais, Yvon; Cubells, C. Luaces; Halevy, Raphaël; Aygün, A. Denizmen; Dalt, Liliana Da; Stefanidis, Constantinos J.; Borght, Thierry Vander; Bigot, S.; Dubos, François; Gervaix, Alain; Chalumeau, Martin

doi:10.1016/j.jpeds.2011.03.008

Cited by 47 publications

(34 citation statements)

References 51 publications

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“…The association of PCT values with VUR in children with febrile UTI remains controversial [25][26][27][28] The current study shows a signifi cant difference in PCT values between children with and without VUR, in accordance to the previously published data [25][26][27][28][31][32][33][34] . An earlier multicenter study of 398 patients in 8 centers in 7 European countries, in which DMSA was not performed in all patients [26] and strongly showed that PCT is a predictor of VUR independently of its relationship with early parenchymal involvement regardless of the urine-collection technique used for the diagnosis of UTI.…”

Section: Discussionsupporting

confidence: 91%

“…The differences in the specifi city values between our study and theirs [25][26][27][28], could be explained keeping in consideration that they used sterile bags to collect urine in non-toilet rained children, which is not the recommended method. This could have led to selection bias, increasing the number of false-positive results for UTI and overestimating in particular the relationship between high-grade VUR and PCT.…”

Section: Discussionmentioning

confidence: 67%

“…Two more studies by Leroy et al [26,28], have also confi rmed the relationship between PCT and VUR. A PCT level of > 0.5 ng/mL gave a sensitivity of 83% and a specifi city of 43% for high-grade VUR, regardless of the presence of early renal parenchymal involvement in children with a fi rst UTI [28].…”

Section: Discussionmentioning

confidence: 88%

“…A PCT level of > 0.5 ng/mL gave a sensitivity of 83% and a specifi city of 43% for high-grade VUR, regardless of the presence of early renal parenchymal involvement in children with a fi rst UTI [28]. The sensitivity of PCT (> 0.5 ng/mL) as a predictor of VUR was 75% for all grades of VUR, and the specifi city was 43% [26].…”

Section: Discussionmentioning

confidence: 97%

“…[25][26][27][28].However, this assumption still needs more confi rmatory studies. The aim of this prospective cohort study was to determine whether we can use serum procalcitonin concentration as a marker of VUR presence or VUR degree in hospitalized children with fi rst febrile UTI.…”

Section: Amongst Bacterial Infections Urinary Tract Infection (Uti)mentioning

confidence: 99%

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Serum Procalcitonin Level is a Useful Predictor of Dilating Vesicoureteral Reflux in Patients with First Febrile Urinary Tract Infection

Shalaby¹,

Elsayed²

2017

Arch Clin Nephrol

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Background: Procalcitonin (PCT) has been proposed as a novel biomarker for prediction of Vesicoureteral Refl ux (VUR). Since VUR is the most important risk factor for occurrence of pyelonephritis and renal tissue infl ammation, serum PCT level may have a relationship with VUR. However, literature about the relationship between procalcitonin level and VUR is scanty. Aim:We evaluated the predictive value of serum PCT level in the diagnosis of VUR in children admitted with their fi rst febrile UTI. Methods:We investigated 140 children with the fi rst febrile UTI (2m-10 yrs.). Serum PCT was measured before initiation of antibiotics. Standard voiding cystourethrography (VCUG) was performed in all children as the gold standard for detection of VUR. Sensitivity and specifi city of a high PCT level was evaluated using the receiver operating characteristic curve.Results: Seventy three patients(52%) had no VUR, while 67patients (48%) had VUR at least in one kidney, including grade 1 to 2 in 20 patients (14.3%) and , grade 3-5 in 47 (34.7%). PCT level ranged from 0.45 ng/ml to 12.7 ng/ml and, was signifi cantly higher with increasing the grading of VUR. Comparing procalcitonin levels with VCUG results, a sensitivity of 94% and a specifi city of 72% was obtained at a procalcitonin level of 0.52 ng/ml for diagnosis dilating VUR. There was a signifi cant correlation between PCT level and C-reactive protein. Conclusion:This study described that the PCT as an infl ammatory marker with proper sensitivity, specifi city, PPV and NPV seems likely benefi cial to predict dilating VUR.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 97%

Section: Amongst Bacterial Infections Urinary Tract Infection (Uti)mentioning

confidence: 99%

See 3 more Smart Citations

Serum Procalcitonin Level is a Useful Predictor of Dilating Vesicoureteral Reflux in Patients with First Febrile Urinary Tract Infection

Shalaby¹,

Elsayed²

2017

Arch Clin Nephrol

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Urinary Tract Infections

2013

Evidence‐Based Neonatal Infections

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Detection of PCT and urinary β₂-MG enhances the accuracy for localization diagnosing pediatric urinary tract infection

et al. 2016

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Objective: The purpose of this article was to investigate whether the combination of urinary beta 2 microglobulin (urinary β 2 -MG) and procalcitonin (PCT) diagnosis could enhance the localization diagnostic precision of pediatric urinary tract infection comparing with single diagnosis. Methods:A study was conducted in the Nephrology Department of Wuhan women and children's health care centre. This study incorporated 85 participants, including 35 children who were diagnosed as upper urinary tract infection (UUTI) with the symptom of fever and 50 children who conducted lower urinary tract infection (LUTI).Levels of PCT and urinary β 2 -MG in both UUTI and LUTI patients were measured and compared.Results: The level of PCT and β 2 -MG were both significantly higher in UUTI group compared with in LUTI group. AUC of urinary β 2 -MG ROC (sensitivity of 71.4%, specificity of 90.0%) was significantly smaller than that of PCT ROC (sensitivity of 77.1%, specificity of 96.0%) in the single diagnosis. Although in the combined diagnosis, the sensitivity and specificity increased to 88.6% and 98%, respectively. Conclusions:Both PCT and β 2 -MG could be used to localize the UTI. Introducing urinary β 2 -MG into PCT diagnosis could increase the sensitivity and specificity of UTI lesion diagnosis in clinical practice. K E Y W O R D Schildren, localization diagnosis, procalcitonin, urinary tract infection, urinary β 2 -MG

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Procalcitonin is a Predictor for High-Grade Vesicoureteral Reflux in Children: Meta-Analysis of Individual Patient Data

Cited by 47 publications

References 51 publications

Serum Procalcitonin Level is a Useful Predictor of Dilating Vesicoureteral Reflux in Patients with First Febrile Urinary Tract Infection

Serum Procalcitonin Level is a Useful Predictor of Dilating Vesicoureteral Reflux in Patients with First Febrile Urinary Tract Infection

Urinary Tract Infections

Detection of PCT and urinary β₂-MG enhances the accuracy for localization diagnosing pediatric urinary tract infection

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Procalcitonin is a Predictor for High-Grade Vesicoureteral Reflux in Children: Meta-Analysis of Individual Patient Data

Cited by 47 publications

References 51 publications

Serum Procalcitonin Level is a Useful Predictor of Dilating Vesicoureteral Reflux in Patients with First Febrile Urinary Tract Infection

Serum Procalcitonin Level is a Useful Predictor of Dilating Vesicoureteral Reflux in Patients with First Febrile Urinary Tract Infection

Urinary Tract Infections

Detection of PCT and urinary β2-MG enhances the accuracy for localization diagnosing pediatric urinary tract infection

Contact Info

Product

Resources

About

Detection of PCT and urinary β₂-MG enhances the accuracy for localization diagnosing pediatric urinary tract infection