Plasma neutrophil gelatinase-associated lipocalin predicts acute pyelonephritis in children with urinary tract infections

Ji Hyun Sim, Hyung-Eun Yim, Byung Min Choi, Jee Hyun Lee, Kee Hwan Yoo

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14 Citations (Scopus)

Abstract

Background: The identification of acute pyelonephritis (APN) is still a challenge.Methods:Patients admitted for their rst urinary tract infection (UTI) were enrolled. Plasma neutrophil gelatinase-associated lipocalin (NGAL) levels were measured at admittance and after treatment. Laboratory, clinical, and imaging results were compared between children with and without APN.Results:A total of 123 patients were enrolled (53 APN and 70 lower UTI). After adjusting for age and gender, plasma NGAL levels were higher in the APN group than in the lower UTI group (233 (129-496) ng/ml vs. 71 (50.8-110) ng/ml, P < 0.001). NGAL levels were correlated with the serum levels of leukocytes, C-reactive protein, and creatinine, as well as fever duration (P < 0.05). Multivariable analysis revealed that log-transformed plasma NGAL was an independent predictor of APN (P < 0.05). Receiver operating curve analysis showed a good diagnostic profile of NGAL for identifying APN (area under the curve 0.864) with a best cut-off value of 102.5 ng/ml. The NGAL levels in both two groups decreased after treatment compared to levels before treatment (P < 0.001).Conclusion:Plasma NGAL can be a sensitive predictor for identifying APN and monitoring the treatment response of pediatric UTI.

Original languageEnglish
Pages (from-to)48-55
Number of pages8
JournalPediatric Research
Volume78
Issue number1
DOIs
Publication statusPublished - 2015 Jan 1

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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