Evaluation of Procalcitonin Serum Levels in Children Younger than Five Years Old with Urinary Tract Infection

Abstract

Background: Children with vesicoureteral reflux (VUR) are posed to the danger of recurrent pyelonephritis, kidney scar and renal failure. Nowadays, the evaluation of VUR is carried out using different imaging methods that are accompanied with different limitations. Pediatricians usually look for other evaluation methods that are feasible, easy to implement and carries the least amount of danger to the patient. 
 Objectives: The aim of this study was to investigate the level of serum Procalcitonin (PCT) as a predictor of VUR instead of the voiding cystourethrogram (VCUG).
 Methods: This case-control study was conducted from 2013 to 2014. One hundred and ten children younger than five years old were divided into two groups: (i) the case group with 76 children diagnosed with urinary tract infection (UTI) using urine culture test, and (ii) the control group with 34 healthy children. Serum levels of PCT were measured by a commercial kit. Demographic data were collected using a questionnaire and analyzed by software SPSS.
 Results: Of the samples, 69.1% of them had no VUR, 20% and 10.9% of the samples suffered from severe unilateral VUR and severe bilateral VUR, respectively. With regard to the level of serum PCT, 61.8% of the samples were positive. One-half of those samples (38 people) who was diagnosed to be healthy had a normal level of serum PCT. However, 30 people (88.2%) of the samples diagnosed to be healthy using VCUG had increased level of serum PCT. The positive and negative predictive values of the level of serum PCT were 44% and 90%, respectively. In this respect, 50% of the samples diagnosed by using level of serum PCT were false positive and 11.8% were false negative. The kappa score for the level of serum PCT was 0.3 (P < 0.0001). The positive predictive value of the serum level of PCT for the female and male samples were 43% and 50% respectively.
 Conclusions: There was no statistically significant relationship between VUR and the serum level of PCT.