Utilidad de los parámetros analíticos en el manejo de los pacientes pediátricos con sospecha de pielonefritis aguda. ¿Es fiable la procalcitonina?

Bañuelos-Andrío, Luis; Espino-Hernández, M.; Ruperez-Lucas, M.; Campo, M.C. Villar-del; Romero-Carrasco, C.I.; Rodríguez-Caravaca, Gil

doi:10.1016/j.remn.2016.05.006

Cited by 4 publications

(4 citation statements)

References 27 publications

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“…Numerous studies have evaluated the usefulness of inflammatory markers for predicting APN, and demonstrated that commonly used laboratory parameters such as WBC, CRP and ESR have low sensitivity and specificity for accurately predicting acute renal parenchymal involvement. At present, these tests are not recommended for routine use to differentiate APN from lower UTI in children [11, 12, 14]. A previous meta-analysis showed that PCT was unable to predict APN in children [12].…”

Section: Discussionmentioning

confidence: 99%

“…Similar to reports of Bańuelos-Andrio et al . and Pathirana et al ., we evaluated infants with febrile and non-febrile UTI [11, 42]. Four children with non-febrile UTI presented a positive DMSA scan.…”

Section: Discussionmentioning

confidence: 99%

“…In clinical practice, fever and acute-phase inflammatory markers such as elevation of white blood cells (WBC), C-reactive protein (CRP), procalcitonin (PCT), and erythrocyte sedimentation rate (ESR) have been used to differentiate between APN and lower UTI [9, 10]. However, these systemic inflammatory markers do not accurately localize the site of the UTI [11, 12].…”

Section: Introductionmentioning

confidence: 99%

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Serum neutrophil gelatinase-associated lipocalin for predicting acute pyelonephritis in infants with urinary tract infection

Krzemień

Pańczyk-Tomaszewska

Kotuła

et al. 2019

cejoi

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Introduction Fever and elevated inflammatory markers have been used for diagnosis of acute pyelonephritis (APN) in infants with urinary tract infection (UTI). The aim of the study was to compare the usefulness of serum neutrophil gelatinase-associated lipocalin (sNGAL) with inflammatory markers for predicting APN in infants with UTI. Material and methods The prospective study included 46 infants with a first episode of UTI, divided into two groups (APN 23, lower UTI 23), according to the DMSA scan results. The following laboratory tests were performed: sNGAL, PCT, CRP, WBC, and ESR. Results Significantly elevated levels of sNGAL, PCT, CRP, and ESR were observed in infants with APN compared to those with lower UTI. Higher sNGAL, CRP, and ESR values, presence of fever, and longer duration of fever before antibiotic treatment were associated with APN [odds ratio (OR) 1.02, 1.27, 1.03, 13.46, 2.12, respectively]. Receiver operating characteristic (ROC) analysis showed better diagnostic profiles for sNGAL, PCT, and CRP than for ESR for predicting APN [area under the curve (AUC) 0.808, 0.819, 0.841, and 0.750, respectively]. The appropriate cut-off values of sNGAL, PCT and CRP were 100.8 ng/ml, 0.15 ng/ml, 5.3 mg/dl (all sensitivity and specificity 82.6%), and that of ESR was 40 mm/h (sensitivity 78.3%, specificity 60.9%). Conclusions sNGAL shows similar usefulness as PCT and CRP for predicting APN in infants with UTI, the diagnostic value of ESR is smaller, and WBC is not useful at all. The presence of fever and longer duration of fever are important predictors of APN in infants with UTI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum neutrophil gelatinase-associated lipocalin for predicting acute pyelonephritis in infants with urinary tract infection

Krzemień

Pańczyk-Tomaszewska

Kotuła

et al. 2019

cejoi

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“…However, it is an invasive test, which radiates the patient and is not available in all centers. On the other hand, there are biomarkers of parenchymal involvement like C-reactive protein (CRP) or procalcitonin (PCT), but none of them are sensitive and specific enough to replace DMSA scan [10][11][12][13]. For this reason, new molecules that can help with an early detection of those patients at risk of kidney damage continue to be investigated [14,15].…”

Section: Introductionmentioning

confidence: 99%

Mr-Proadrenomedullin As Biomarker Of Renal Damage In Urinary Tract Infection In Children

Penedo

Lucas

Welther

et al. 2021

Preprint

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Background: Midregional-proadrenomedullin (MR-proADM) is a useful prognostic peptide in severe infectious pathologies in the adult population. However, there are no studies that analyze its utility in febrile urinary tract infection (fUTI) in children. An accurate biomarker would provide an early detection of patients with kidney damage, avoiding other invasive tests like renal scintigraphy scans. Our objective is to study the usefulness of MR-proADM as a biomarker of acute and chronic renal parenchymal damage in fUTI within the pediatric population. Material and Methods: A prospective cohort study was conducted in pediatric patients with fUTI between January 2015 and December 2018. Plasma and urine MR-proADM levels were measured at admission in addition to other laboratory parameters. After confirmation of fUTI, renal scintigraphy scans were performed during the acute and chronic stages. A descriptive study has been carried out and sensitivity, specificity and ROC curves for MR-proADM, C-reactive protein, and procalcitonin were calculated. Results: 62 pediatric patients (34 women) were enrolled. Scintigraphy showed acute pyelonephritis in 35 patients (56.5%). Of those patients, median of plasmatic MR-proADM (P-MR-proADM) showed no differences compared to patients without pyelonephritis. 7 patients (11.3%) developed renal scars (RS). Their median P-MR-proADM levels were 1.07 nmol/L (IQR 0.66 – 1.59), while in patients without RS were 0.48 nmol/L (0.43 – 0.63) (p<0.01). The AUC in this case was 0.92 (95% CI 0.77 – 0.99). We stablished an optimal cut-off point at 0.66 nmol/L with sensitivity 83.3% and specificity 81.8%. Conclusion: MR-ProADM has a poor ability to diagnose pyelonephritis in pediatric patients with fUTI. However, P-MR-proADM showed as a very reliable biomarker for RS prediction. Keywords: Proadrenomedullin, biomarker, urinary tract infection, pediatric, renal scarring

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Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children

Shaikh

Osio

Leeflang

et al. 2020

Cochrane Database of Systematic Reviews

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Utilidad de los parámetros analíticos en el manejo de los pacientes pediátricos con sospecha de pielonefritis aguda. ¿Es fiable la procalcitonina?

Cited by 4 publications

References 27 publications

Serum neutrophil gelatinase-associated lipocalin for predicting acute pyelonephritis in infants with urinary tract infection

Serum neutrophil gelatinase-associated lipocalin for predicting acute pyelonephritis in infants with urinary tract infection

Mr-Proadrenomedullin As Biomarker Of Renal Damage In Urinary Tract Infection In Children

Procalcitonin, C-reactive protein, and erythrocyte sedimentation rate for the diagnosis of acute pyelonephritis in children

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