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Pediatric Nephrology

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29.07.2017 | Original Article

Urine neutrophil gelatinase-associated lipocalin and other biomarkers in infants with urinary tract infection and in febrile controls

verfasst von: Sindri Valdimarsson, Ulf Jodal, Lars Barregård, Sverker Hansson

Erschienen in: Pediatric Nephrology | Ausgabe 11/2017

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Abstract

Background

Urine biomarkers are commonly used in the evaluation of acute kidney injury, and are gaining attention as tools for studying urinary tract infections (UTIs). We analyzed neutrophil gelatinase-associated lipocalin (NGAL) and seven other urine biomarkers to evaluate their usefulness in the diagnosis of UTI in infants.

Methods

Eight urine biomarkers were analyzed in 108 infants with UTI. Controls were 64 febrile children without UTI and 13 healthy children. Logistic regression and construction of receiver operating characteristic (ROC) curves were performed for UTI patients versus febrile controls for all biomarkers.

Results

The best biomarkers to differentiate between UTI and febrile controls were NGAL and interleukin 8 (IL8). Urine NGAL in absolute concentration and adjusted for creatinine had a sensitivity of 93% and 96% and a specificity of 95% and 100% for diagnosing UTI, with a cut-off concentration of 38 ng/mL and 233 ng/mg respectively.

Conclusions

Urine biomarkers, particularly NGAL, can aid in the diagnosis of UTI among febrile infants. The results suggest that in infants with fever and high NGAL, UTI is most likely, whereas in infants with fever and low NGAL, other causes of fever should be looked for.

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Jakobsson B, Esbjorner E, Hansson S (1999) Minimum incidence and diagnostic rate of first urinary tract infection. Pediatrics 104:222–226CrossRefPubMed

Roberts KB (2011) Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 128:595–610CrossRefPubMed

Jacobson SH, Eklof O, Eriksson CG, Lins LE, Tidgren B, Winberg J (1989) Development of hypertension and uraemia after pyelonephritis in childhood: 27 year follow up. BMJ 299:703–706CrossRefPubMedPubMedCentral

Bitsori M, Karatzi M, Dimitriou H, Christakou E, Savvidou A, Galanakis E (2011) Urine IL-8 concentrations in infectious and non-infectious urinary tract conditions. Pediatr Nephrol 26:2003–2007CrossRefPubMed

Ichino M, Kusaka M, Kuroyanagi Y, Mori T, Morooka M, Sasaki H, Shiroki R, Shishido S, Kurahashi H, Hoshinaga K (2010) Urinary neutrophil-gelatinase associated lipocalin is a potential noninvasive marker for renal scarring in patients with vesicoureteral reflux. J Urol 183:2001–2007CrossRefPubMed

Wasung ME, Chawla LS, Madero M (2015) Biomarkers of renal function, which and when? Clin Chim Acta 438:350–357CrossRefPubMed

Kanellopoulos TA, Vassilakos PJ, Kantzis M, Ellina A, Kolonitsiou F, Papanastasiou DA (2005) Low bacterial count urinary tract infections in infants and young children. Eur J Pediatr 164:355–361CrossRefPubMed

Labrosse M, Levy A, Autmizguine J, Gravel J (2016) Evaluation of a new strategy for clean-catch urine in infants. Pediatrics 138(3):e20160573CrossRefPubMed

Parikh CR, Butrymowicz I, Yu A, Chinchilli VM, Park M, Hsu CY, Reeves WB, Devarajan P, Kimmel PL, Siew ED, Liu KD (2014) Urine stability studies for novel biomarkers of acute kidney injury. Am J Kidney Dis 63:567–572CrossRefPubMed

10.

Hornung RW, Reed LD (1990) Estimation of average concentration in the presence of nondetectable values. Appl Occup Environ Hyg 5:46–51CrossRef

11.

Sharief N, Hameed M, Petts D (1998) Use of rapid dipstick tests to exclude urinary tract infection in children. Br J Biomed Sci 55:242–246PubMed

12.

Wang PY, Chang HC, Lei RL, Kao JK, Wu CL, Lee CH, Tseng YC, Lin LY, Lee MS (2016) Personal history and physical examination in judgment of urinary tract infection in children aged 3 months to 2 years. Pediatr Neonatol 57:274–279CrossRefPubMed

13.

Andersson L, Preda I, Hahn-Zoric M, Hanson LA, Jodal U, Sixt R, Barregard L, Hansson S (2009) Urinary proteins in children with urinary tract infection. Pediatr Nephrol 24:1533–1538CrossRefPubMed

14.

Bernard AM, Thielemans NO, Lauwerys RR (1994) Urinary protein 1 or Clara cell protein: a new sensitive marker of proximal tubular dysfunction. Kidney Int Suppl 47:S34–S37PubMed

15.

Johansson S, Kristjansson S, Bjarnarson SP, Wennergren G, Rudin A (2009) Clara cell protein 16 (CC16) serum levels in infants during respiratory syncytial virus infection. Acta Paediatr 98:579–581CrossRefPubMed

16.

Swerkersson S, Jodal U, Ahren C, Sixt R, Stokland E, Hansson S (2016) Urinary tract infection in infants: the significance of low bacterial count. Pediatr Nephrol 31:239–245CrossRefPubMed

17.

Yim HE, Yim H, Bae ES, Woo SU, Yoo KH (2014) Predictive value of urinary and serum biomarkers in young children with febrile urinary tract infections. Pediatr Nephrol 29:2181–2189CrossRefPubMed

18.

Yilmaz A, Sevketoglu E, Gedikbasi A, Karyagar S, Kiyak A, Mulazimoglu M, Aydogan G, Ozpacaci T, Hatipoglu S (2009) Early prediction of urinary tract infection with urinary neutrophil gelatinase associated lipocalin. Pediatr Nephrol 24:2387–2392CrossRefPubMed

19.

Cangemi G, Storti S, Cantinotti M, Fortunato A, Emdin M, Bruschettini M, Bugnone D, Melioli G, Clerico A (2013) Reference values for urinary neutrophil gelatinase-associated lipocalin (NGAL) in pediatric age measured with a fully automated chemiluminescent platform. Clin Chem Lab Med 51:1101–1105CrossRefPubMed

20.

Zhou F, Luo Q, Wang L, Han L (2016) Diagnostic value of neutrophil gelatinase-associated lipocalin for early diagnosis of cardiac surgery-associated acute kidney injury: a meta-analysis. Eur J Cardiothorac Surg 49:746–755CrossRefPubMed

21.

Zappitelli M, Washburn KK, Arikan AA, Loftis L, Ma Q, Devarajan P, Parikh CR, Goldstein SL (2007) Urine neutrophil gelatinase-associated lipocalin is an early marker of acute kidney injury in critically ill children: a prospective cohort study. Crit Care 11:R84CrossRefPubMedPubMedCentral

22.

Schmith-Ott KM, Mori K, Li JY, Kalandadze A, Cohen DJ, Devarajan P, Barasch J (2007) Dual action of neutrophil gelatinase-associated lipocalin. J Am Soc Nephrol 18:407–413CrossRef

23.

Paragas N, Kulkarni R, Werth M, Schmidt-Ott KM, Forster C, Deng R, Zhang Q, Singer E, Klose AD, Shen TH, Francis KP, Ray S, Vijayakumar S, Seward S, Bovino ME, Xu K, Takabe Y, Amaral FE, Mohan S, Wax R, Corbin K, Sanna-Cherchi S, Mori K, Johnson L, Nickolas T, D’Agati V, Lin CS, Qiu A, Al-Awqati Q, Ratner AJ, Barasch J (2014) α-intercalated cells defend the urinary system from bacterial infection. J Clin Invest 124:2963–2976CrossRefPubMedPubMedCentral

24.

Makris K, Stefani D, Makri E, Panagou I, Lagiou M, Sarli A, Lelekis M, Kroupis C (2015) Evaluation of a particle enhanced turbidimetric assay for the measurement of neutrophil gelatinase-associated lipocalin in plasma and urine on architect-8000: analytical performance and establishment of reference values. Clin Biochem 48:1291–1297CrossRefPubMed

25.

Tullus K, Fituri O, Burman LG, Wretlind B, Brauner A (1994) Interleukin-6 and interleukin-8 in the urine of children with acute pyelonephritis. Pediatr Nephrol 8:280–284CrossRefPubMed

26.

Hedges JC, Singer CA, Gerthoffer WT (2000) Mitogen-activated protein kinases regulate cytokine gene expression in human airway myocytes. Am J Respir Cell Mol Biol 23:86–94CrossRefPubMed

27.

Gokce I, Alpay H, Biyikli N, Unluguzel G, Dede F, Topuzoglu A (2010) Urinary levels of interleukin-6 and interleukin-8 in patients with vesicoureteral reflux and renal parenchymal scar. Pediatr Nephrol 25:905–912CrossRefPubMed

28.

Tullus K (2016) Low urinary bacterial counts: do they count? Pediatr Nephrol 31:171–174CrossRefPubMed

Titel: Urine neutrophil gelatinase-associated lipocalin and other biomarkers in infants with urinary tract infection and in febrile controls
verfasst von: Sindri Valdimarsson
Ulf Jodal
Lars Barregård
Sverker Hansson
Publikationsdatum: 29.07.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 11/2017
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-017-3709-1

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Urine neutrophil gelatinase-associated lipocalin and other biomarkers in infants with urinary tract infection and in febrile controls

Abstract

Background

Methods

Results

Conclusions

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Abstract

Background

Methods

Results

Conclusions

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