Neutrophil gelatinase-associated lipocalin for urinary tract infection and pyelonephritis: a systematic review

Shaikh, Kai; Rajakumar, Vinod; Osio, Victor A.; Shaikh, Nader

doi:10.1007/s00467-020-04854-3

Cited by 17 publications

(13 citation statements)

References 24 publications

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“…Accordingly, the role of different biomarkers in the study and prognosis of patients with urinary tract infection has been investigated in both serum and urine samples. [11][12][13][14][15][16][17][18][19][20][21]34 In our study, we evaluated the urinary concentrations of different biomarkers in 92 paediatric patients with DMSA-confirmed APN.…”

Section: Discussionmentioning

confidence: 99%

“…Control of this inflammatory cascade could reduce the risk of scarring after an episode of APN, thus reducing the subsequent risk of long‐term complications. Accordingly, the role of different biomarkers in the study and prognosis of patients with urinary tract infection has been investigated in both serum and urine samples 11–21,34 . In our study, we evaluated the urinary concentrations of different biomarkers in 92 paediatric patients with DMSA‐confirmed APN.…”

Section: Discussionmentioning

confidence: 99%

“…The results of each biomarker were divided by urine creatinine, measured with the Jaffe method using a kinetic colorimetric assay for normalisation 32 . These biomarkers were selected according to previous literature and the technical possibility to be detected altogether in a multiplex analysis 11–20 …”

Section: Methodsmentioning

confidence: 99%

“…32 These biomarkers were selected according to previous literature and the technical possibility to be detected altogether in a multiplex analysis. [11][12][13][14][15][16][17][18][19][20] Pearson's chi-squared test was used for the statistical comparison of the categorical data. Correlations between quantitative variables were performed by Pearson or Spearman tests as appropriate.…”

Section: Key Notesmentioning

confidence: 99%

“…Thus, even after adequate antimicrobial management, in some cases, the inflammatory process will lead to kidney scarring due to the robust immune response after the stimulation of proinflammatory cytokines 10 . The analysis of serum and urine cytokines, mainly interleukin (IL) 6 and IL8, and other biomarkers like neutrophil gelatinase‐associated lipocalin‐2 (NGAL/Lipocalin‐2), is emerging in the literature, showing higher levels of these proteins in children and adults with UTI and kidney damage 11–20 . Considering this hypothesis, the role of anti‐inflammatory treatment has been assessed as a potential control of cytokine cascade.…”

Section: Introductionmentioning

confidence: 99%

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Role of dexamethasone in controlling the proinflammatory cytokine cascade in the first episode of paediatric acute pyelonephritis

Rius‐Gordillo,

Ferré,

González

et al. 2023

Acta Paediatrica

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AimFebrile urinary tract infection is a common bacterial infection in childhood. The kidney damage after acute pyelonephritis (APN) could be related to the stimulation of the proinflammatory response. We aimed to investigate the role of inflammatory cytokines and the effect of dexamethasone after a first episode of APN.MethodsSubanalysis of the DEXCAR RCT in which children with confirmed APN (1 month–14 years) were randomly assigned to receive a 3 days course of either intravenous dexamethasone or placebo. Urinary cytokine levels at diagnosis and after 72 h of treatment were measured.ResultsNinety‐two patients were recruited. Younger patients, males and those with abnormalities in the ultrasound study or vesicoureteral reflux showed higher values of urinary cytokines. Patients with severe APN had higher Tumour Necrosis Factor (TNF)α levels (81.0 ± 75.8 vs. 33.6 ± 48.5 pg/mg creatinine, p = 0.015). Both intervention groups showed similar basal clinical characteristics, including urinary cytokine levels. Treatment reduced urinary cytokine levels irrespective of dexamethasone administration. Neither the intervention group nor the urinary cytokine levels modulated the development of kidney scars.ConclusionBasal urinary cytokines were associated with age, abnormal ultrasound and vesicoureteral reflux. Patients with severe APN had higher TNFa urinary levels. Administration of dexamethasone in children with APN does not improve the control of the proinflammatory cytokine cascade.

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