Urinary Protein and Enzyme Excretion of Spot Urine in Children with Vesicoureteral Reflux

Yoon, Jung Rim; Koo, Ja Wook

doi:10.3339/jkspn.2009.13.1.56

Cited by 3 publications

(6 citation statements)

References 19 publications

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“…In this study VUR, VUR grade, renal parenchymal defect and renal scar were not correlated to microalbuminuria. The discrepancy between the findings reported in our study and reported by Yoon et al 5) is likely due to difference of mean age of patients, severity of disease. Therefore further longitudinal follow-ups are required to confirm the apparent absence of correlation.…”

Section: Discussioncontrasting

confidence: 99%

“…Few study investigated spot urine microalbumin/creatinine ratio in children 5 , 6) . Several prior reports indicated that spot urine samples provide a good estimate of the 24-hour excretion rate 20 , 21) .…”

Section: Discussionmentioning

confidence: 99%

“…A limitation of this study is that only one spot urine microalbumin/creatinine ratio was obtained, and it was not compared to timed urine collections. Yoon et al 5) reported that the spot urine microalbumin/creatinine ratio was significantly increased in children with VUR and renal defects. Basic et al 18) determined the presence of microalbuminuria and decreased creatinine clearancerate (CCR) in children with high grade of VUR.…”

Section: Discussionmentioning

confidence: 99%

“…It is known as a predictor of clinical nephropathy in patients with diabetes mellitus, and a risk factor of cardiomyopathy and nephropathy in the general adult population 4) . Few studies have investigated microalbuminuria in children and the validity of prescreening by measuring microalbuminin in spot urine samples to identify children with urinary tract infection (UTI) 5 , 6) . We therefore elected to compare the spot urine microalbumin/creatinine ratios of pediatric patients with UTI (patient group) with that of healthy control subjects (control group).…”

Section: Introductionmentioning

confidence: 99%

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Microalbuminuria in children with urinary tract infection

2010

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PurposeMicroalbuminuria is defined as increased urinary albumin excretion (30-300 mg/day) or microalbumin/creatinine ratio (30-300 mg/g) in a spot urine sample. Although microalbuminuria is a predictor of clinical nephropathy and cardiomyopathy, few studies have investigated microalbuminuria in children with urinary tract infection (UTI).MethodsTherefore, we compared the spot urine microalbumin/creatinine ratio in pediatric UTI patients with that of control subjects. We investigated the correlation between the ratio in children with UTI and age, height, weight, blood pressure, glomerular filtration rate (GFR), hematuria, vesicoureteral reflux, renal parenchymal defect, and renal scar, and its predictability for UTI complications.ResultsWe studied 66 patients (42 boys, 24 girls) and 52 healthy children (24 boys, 28 girls). The mean microalbumin/creatinine ratio in UTI patients was statistically significantly increased compared to the control group (340.04±321.36 mg/g (38.47±36.35 mg/mmol) in patient group vs. 225.68±154.61 mg/g (25.53±17.49 mg/mmol) in control group, P=0.0141). The mean value of spot urine microalbumin/creatinine ratio (384.70±342.22 mg/g (43.47±37.67 mg/mmol) in patient group vs. 264.92±158.13 mg/g (29.94±17.86 mg/mmol) in control group, P=0.0341) in 1-23 months age patient group showed statistically significant increase compared to control group. Microalbumin/creatinine ratio showed negative correlation to age (r=-0.29, P=0.0167), body surface area (BSA) (r=-0.29, P=0.0173) and GFR (r=-0.26, P=0.0343). The presence of hematuria (P=0.0169) was found to be correlated.ConclusionThe spot urine microalbumin/creatinine ratio in children with UTI was significantly greater than that in normal children, and it was positively correlated with GFR. This ratio is a potential prescreening and prognostic marker in UTI patients. Further studies are required to validate the predictability of microalbuminuria in pediatric UTI patients.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Microalbuminuria in children with urinary tract infection

2010

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“…92 Urinary microalbumin excretion may be a useful marker to predict the severity of VUR. 93 There is an insignificant increase of microalbuminuria and decrease of creatinine clearance in children with a high grade of VUR, as a possible consequence of retrograde urine flow (intrarenal reflux), glomerulosclerosis, and consecutive hyperfiltration. 94 The spot urine microalbumin/creatinine ratio is significantly increased in children with previous UTI and VUR.…”

Section: Risk Factorsmentioning

confidence: 99%

Predictive Risk Factors in Childhood Urinary Tract Infection, Vesicoureteral Reflux, and Renal Scarring Management

Roupakias

Sinopidis

Karatza

et al. 2013

Clin Pediatr (Phila)

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Approaches to the management of children with urinary tract infection (UTI), vesicoureteral reflux (VUR), and renal scars have been challenged and have become controversial over the past decade. It is difficult to determine when, how, and which patients will benefit from the diagnosis and management of this condition. Therefore, the issues of diagnostic imaging, observation, follow-up, and intervention tend to be decided more on a case-by-case basis, rather than by using an algorithm. Over the past few years, there have been advances in the identification of risk factors that predispose patients with UTI to present with VUR, to develop recurrent UTIs and renal scars, to have deteriorating renal function, to show VUR improvement and/or spontaneous resolution, and to be candidates for and benefit from early surgical intervention.

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Usefulness of Spot Urine β2-microglobulin in Pediatric Acute Pyelonephritis

Oh¹,

Bae²,

Kim³

et al. 2012

Soonchunhyang Med Sci

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Objective: It is difficult to make a distinction between acute pyelonephritis and lower urinary tract infection due to nonspecific clinical symptoms and laboratory findings. We measured the spot urine β2-microglobulin in children with urinary tract infection (UTI) to distinguish between acute pyelonephritis and lower UTI. We compared the accuracy of urine β2-microglobulin measurement with other inflammatory markers. Methods: We studied 83 children (mean, 86± 44.9 months) who suspected of having UTI. Leukocyte counts, erythrocyte sedimentation rates (ESR) and C-reactive protein (CRP), β2-microglobulin were measured. Renal parenchymal involvement was evaluated by 99mTc dimercaptosuccinic acid scintigraphy in the first 7 days after admission. β2-microglobulin was measured by radioimmunoassay. Results: Urine β2-microglobulin values were correlated with the presence of renal defects in children with UTI (n= 22) (0.98± 0.24 μg/mL, P< 0.05). Using a cutoff of 0.4 μg/mL for spot urine β2-microglobulin and 20 mm/hr for ESR, 2.6 mg/L for CRP, sensitivity and specificity between UTI with and without renal involvement were 78.7% and 90.1% for spot urine β2-microglobulin, 77.2% and 90.1% for spot urine β2-microglobulin/creatinine (Cr), 77.2%, 68.8% for ESR, 86.3%, 68.8% for CRP, respectively. Positive and negative predictive values were 72.7%, 90.1% for spot urine β2-microglobulin, 73.9% and 91.6% for spot urine β2-microglobulin/Cr, and 57.5%, 94% for CRP, respectively. Conclusion: In febrile UTI, spot urine β2-microglobulin and β2-microglobulin/Cr values were more specific than CRP, ESR, and leukocyte count for determine the renal defects.

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Urinary Protein and Enzyme Excretion of Spot Urine in Children with Vesicoureteral Reflux

Cited by 3 publications

References 19 publications

Microalbuminuria in children with urinary tract infection

Microalbuminuria in children with urinary tract infection

Predictive Risk Factors in Childhood Urinary Tract Infection, Vesicoureteral Reflux, and Renal Scarring Management

Usefulness of Spot Urine β2-microglobulin in Pediatric Acute Pyelonephritis

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