Urinary proteins in children with urinary tract infection

Abstract

The aim of this study was to test our hypothesis that the urinary excretion of C-reactive protein (CRP), alpha 1-microglobulin (A1M), retinol-binding protein (RBP) and Clara cell protein (CC16) is increased in children with urinary tract infection (UTI) and relates to renal damage as measured by acute dimercaptosuccinic acid (DMSA) scintigraphy. Fifty-two children <2 years of age with UTI were enrolled in the study, 44 of whom were febrile. The control group consisted of 23 patients with non-UTI infection and elevated serum CRP (s-CRP) levels. Thirty-six patients had abnormal DMSA uptake, classified as mild, moderate or severe damage (DMSA class 1, 2, 3, respectively). There was a significant association between DMSA class and the excretion of urinary RBP (u-RBP) and u-CC16. There was also a significant difference in u-CRP levels between children with UTI and control children with non-UTI infections, although u-CRP excretion was not significantly correlated to DMSA class. In conclusion, the urinary excretion of the low-molecular-weight proteins RBP and CC16 showed a strong association with uptake defects on renal DMSA scans. The urinary level of CRP seems to distinguish between children with UTI and other febrile conditions. A combination of these biomarkers may be useful in the clinical assessment of children with UTI.

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

“…Our study is the first to describe the presence of HBP in urine and to investigate its potential as a marker for UTI. Several other biomarker candidates have previously been studied-IL-6, lactoferrin, IL-8, tumor necrosis factor alpha, elastase, and Clara cell protein [7,8,[19][20][21][22][23]. Among these, U-IL-6 showed the most promising results, especially in terms of differentiating pyelonephritis from lower UTI [23].…”

Asociación entre el reflujo vesicoureteral y la nefroesclerosis en las infecciones urinarias

“…Según los estudios, el valor de PCR es significativamente más alto al momento del ingreso cuando se detecta daño renal por gammagrafía con DMSA tras una pielonefritis. [21][22][23][24] Del mismo modo, en este estudio, se detectó mayor nefroesclerosis en los pacientes con valores positivos de PCR, y se halló una diferencia estadísticamente significativa entre estos pacientes y aquellos con valores negativos de PCR (p < 0,0001).…”

Oxidative status parameters in children with urinary tract infection

“…Condition of prolonged inflammation during UTI can lead to development of fibrosis and renal scar formation (8). Baseline values of TAS were higher in patients with longer duration of inflammation, which was confirmed by measuring the inflammatory marker CRP at the time of hospital discharge.…”

“…This is an invasive and expensive technique that is not always available, and a search for non-invasive methods therefore deems necessary (8). Motivated by the growing awareness of the impact that oxidative stress plays in the pathophysiology of kidney diseases, this study was created primarily with a desire to consider the role of new parameters and non-invasive method in assessing the condition and the outcome of a disease in paediatric patients with a diagnosis of UTI.…”