ESPN 51th Annual Meeting

ESPN 2018


 
A Preliminary Study in the Plasma Neutrophil Gelatinase-Associated Lipocalin for Predicting Renal Parenchymal Involvement in Infants with Febrile Urinary Tract Infection
JIN-SOON SUH 2 EUN MI YANG 1 CHAN JONG KIM 1

1- CHONNAM NATIONAL UNIVERSITY HOSPITAL
2- CATHOLIC UNIVERSITY OF KOREA BUCHEON ST. MARYS HOSPITA
 
Introduction:

 Urinary tract infection (UTI) is the most common bacterial infections in infants. Renal parenchymal involvement is an important prognostic factor; however, early detection of parenchymal involvement in UTI may be difficult during infancy. The aim of this study was to assess whether a recently established biomarker of UTI, neutrophil gelatinase-associated lipocalin (NGAL), could be a useful marker for detection of cortical defects and to determine the appropriate diagnostic cutoff value in infants with febrile UTI.

Material and methods:

 Infants hospitalized for febrile UTI were enrolled and divided into two groups according to the presence of cortical defects on dimercaptosuccinicacid scintigraphy. The white blood cell count, C-reactive protein, and plasma NGAL (pNGAL) level were determined before antibiotic therapy and values were compared between the two groups.

Results:

 Among 64 enrolled infants, 43 (67%) had a cortical defect (UTI-CD) and 21 (33%) had no cortical defect (UTI-ND) on renal scintigraphy. The level of pNGAL was significantly higher in UTI-CD group than in the UTI-ND group (340 ng/mL vs. 214 ng/mL, P=0.002). Multivariate analysis showed that pNGAL level was the only independent predictor of a cortical defect (odds ratio 2.759, P=0.039). pNGAL showed the highest area under the receiver operating characteristic curves value of 0.745 (95% confidence interval, 0.561-0.821, P=0.014). The appropriate cut-off value of pNGAL was 267 ng/ml (sensitivity, 72.1%; specificity, 71.4%).

Conclusions:

 In this preliminary study, pNGAL is a useful marker for early prediction of renal parenchymal involvement in infant with febrile UTI.