The diagnosis of febrile urinary tract infection in children may be facilitated by urinary biomarkers

Lee, Hahn Ey; Kim, Do Kyun; Kang, Hee Kyung; Park, Kwanjin

doi:10.1007/s00467-014-2905-5

Cited by 36 publications

(47 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We are still trying to find noninvasive, diagnostic methods for assessment of renal parenchymal damage [19]. Potential targets are various biomarkers, which can be useful in diagnosis of UTI [20]. Unfortunately, previous results regarding IL-6 and IL-8 in serum and urine in children with UTI have been equivocal [9, 21].…”

Section: Introductionmentioning

confidence: 99%

Urine interleukin-6, interleukin-8 and transforming growth factor β1 in infants with urinary tract infection and asymptomatic bacteriuria

Krzemień¹,

Szmigielska²,

Turczyn³

et al. 2016

cejoi

View full text Add to dashboard Cite

IntroductionUrinary tract infection (UTI) occurs in 1.1% of girls and 1.4% of boys during the first year of life. Asymptomatic bacteriuria (ABU) is usually detected incidentally in 0.9% of girls and 2.5% of boys at this age. The aim of the study was to assess the usefulness of measurement of pro-inflammatory urine interleukin (IL)-6 and IL-8 concentrations and anti-inflammatory transforming growth factor β1 (TGF-β1) level in infants with febrile UTI, non-febrile UTI and ABU.Material and methodsA total of 35 children, mean age 6.14 ±3.47 months, were divided into three groups: group I – febrile UTI (n = 13), group II – non-febrile UTI (n = 13) and group III – ABU (n = 9). At the time of enrollment urine IL-6, IL-8, TGF-β1 and serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) were measured. Renal ultrasound was performed in all children, 99mTc-dimercaptosuccinic acid scintigraphy (DMSA) and voiding cystourethrography in children with UTI.ResultsUrine concentrations of IL-6 and IL-8 were significantly higher in febrile UTI compared to those with non-febrile UTI and ABU (p < 0.5, p < 0.01) and positively correlated with CRP, ESR and WBC (p < 0.01). Urine levels of TGF-β1 were significantly higher in children with febrile UTI compared to those with ABU (p < 0.05) and positively correlated with WBC (p < 0.01). Inflammatory changes in the DMSA scan were detected in 66.6% of children with UTI. No significant difference in frequency of an abnormal DMSA scan compared to a normal scan was found in groups with febrile and non-febrile UTI. No relations between urine cytokines, systemic inflammatory markers and changes in DMSA scan were observed. The cutoff value for detection of inflammatory changes in the DMSA scan for IL-8 was 120 pg/mg creatinine (Cr) and 40 pg/mg Cr for TGF-β1. Based on this value, the sensitivity for IL-8 was 58.3%, specificity 100% and for TGF-β1 66.7% and 83.7%, respectively.ConclusionsWe found significant differences in children with febrile UTI and ABU regarding urine IL-6, IL-8 and TGF-β1 levels. Urine cytokines and systemic inflammatory markers do not differentiate between upper and lower UTI in infants.

show abstract

Section: Introductionmentioning

confidence: 99%

Urine interleukin-6, interleukin-8 and transforming growth factor β1 in infants with urinary tract infection and asymptomatic bacteriuria

Krzemień¹,

Szmigielska²,

Turczyn³

et al. 2016

cejoi

View full text Add to dashboard Cite

show abstract

“…The three main biomarkers: Kidney injury molecule -1(KIM-1), Cystatin-c and Lipocalin (NGAL) have been presented. [17][18][19][20] The validity of NGAL was assessed in two recent study; Ghassemi reported that with the cutoff point of 5 mg/L the NGAL get the NPV of 76.3%, the specificity of 97.83%, the PPV of 96.7%, and the sensitivity of 67.4% in diagnosis of APN. [21] Nickavar found that using a cutoff of 0.20 ng/mL, …”

Section: Discussionmentioning

confidence: 99%

Urinary matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 biomarkers for predicting renal scar in children with urinary tract infection

Abedi

Mohammadjafari

Rafiei

et al. 2017

Turkish Journal of Urology

View full text Add to dashboard Cite

Objective: Urinary tract infection occurs in 1.8-6.6% of children under 6 years old. The aim of this study was to assess the urinary concentrations of matrix metalloproteinase 9 (MMP9) and tissue inhibitor of metalloproteinase 1 (TIMP1), in children with acute pyelonephritis (APN) and the potential to develop renal scarring. Material and methods:Children who had experienced an episode of APN were divided into 2 groups. Group 1 included children with APN who exhibited scarring and group 2 included children with APN who had a normal 99m Technetium dimercaptosuccinic acid scan. Urinary levels of MMP9 and TIMP1 were measured in the acute phase of infection. A receiver operating characteristic curve was generated to allow calculation of cut-off values.Results: Sixty-one children were enrolled across the 2 groups: group 1 contained 16 patients (all female); group 2, 38 children (36 female and 2 male). Urinary levels of MMP9 and TIMP1 were significantly higher in group 1 than in group 2 (p= 0.037 and 0.022 respectively). For comparison of groups 1 and 2, the cut-off values were measured as 75.5 ng/mL (sensitivity 62.5%, specificity 71.1%, positive predictive value, PPV, 48%, negative predictive value, NPV, 82%), 16.1 ng/mL (sensitivity 75%, specificity 55.3%, PPV 41%, NPV 84%), and 1310.7 ng/mL (sensitivity 75% specificity 60.5%, PPV 44%, NPV 85%) for MMP9, TIMP1, and MMP9×TIMP1 levels, respectively. Conclusion:Evaluation of urinary MMP9 and TIMP1 levels may help to identify children with APN who are at risk of developing renal scarring.Keywords: Children; matrix metalloproteinase; pyelonephritis; tissue inhibitor of metalloproteinase 1; urinary tract infection; vesico-ureteral reflux.Cite this article as: Abedi SM, Mohammadjafari H, Rafiei A, Bazi S, Yazdani P. Urinary matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 biomarkers for predicting renal scar in children with urinary tract infection. Turk J Urol 2017; 43(4): 536-42.

show abstract

“…It occurs in 5.7-8.3% of girls presenting with fever in the first year of life and varies from 8.7% in febrile boys aged < 3 months to 1.7% in febrile boys aged 6 months to 1 year [2]. The diagnosis of UTI in infants is challenging due to nonspecific UTI symptoms in this age [3,4]. Moreover, difficulty in specimen collection, non-infection pyuria, and the high risk of contamination of urine may contribute to its misdiagnosis in infants [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, difficulty in specimen collection, non-infection pyuria, and the high risk of contamination of urine may contribute to its misdiagnosis in infants [5,6]. The waiting time required for urine culture results poses another problem [3,7]. Paediatricians may be confused as to whether antibiotic treatment should be started before obtaining the results of urine culture [5].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prognostic value of serum and urine kidney injury molecule-1 in infants with urinary tract infection

Krzemień¹,

Turczyn²,

Pańczyk-Tomaszewska³

et al. 2019

cejoi

View full text Add to dashboard Cite

Introduction: Kidney injury molecule-1 (KIM-1) is an important diagnostic and prognostic marker in acute kidney injury and chronic kidney disease of various aetiologies. The aim of the study was to evaluate the usefulness of serum KIM-1 (sKIM-1) and urine for predicting febrile and non-febrile urinary tract infection (UTI) in infants.Material and methods: A prospective study included 101 children divided into three groups: febrile UTI 49 children, non-febrile UTI 22 children, and healthy controls 30 children. The following laboratory tests were performed: sKIM-1, uKIM-1, white blood count (WBC), C-reactive protein (CRP), and procalcitonin (PCT).Results: Median levels of sKIM-1 were significantly higher in the febrile and non-febrile UTI group compared to the healthy controls (both p < 0.05). Mean levels of uKIM-1 were significantly lower in the febrile UTI group compared to the non-febrile UTI group and healthy controls (p < 0.001 and p < 0.0001, respectively). Univariate logistic regression analysis has demonstrated a positive association of sKIM-1 with febrile and non-febrile UTI (both p < 0.05), and negative association uKIM-1 with febrile UTI (p < 0.0001). Receiver operating curve (ROC) analysis showed good diagnostic profiles of uKIM-1 with a best cut-off value of 2.4 ng/ml and sKIM-1 with a best cut-off value of 3.88 ng/ml for predicting febrile UTI (area under the curve [AUC] 0.82 and 0.67, sensitivity 73% and 63%, specificity 86% and 80%, respectively).Conclusions: sKIM-1 can be useful for predicting febrile UTI. We do not recommended use of uKIM-1 as a marker of febrile UTI because of its negative association with febrile UTI. Both markers are not useful for predicting non-febrile UTI.

show abstract

The diagnosis of febrile urinary tract infection in children may be facilitated by urinary biomarkers

Abstract: The diagnosis of febrile UTI and the prediction of subsequent scarring may be facilitated by assaying urine biomarkers with acceptable accuracy.

Cited by 36 publications

References 21 publications

Urine interleukin-6, interleukin-8 and transforming growth factor β1 in infants with urinary tract infection and asymptomatic bacteriuria

Urine interleukin-6, interleukin-8 and transforming growth factor β1 in infants with urinary tract infection and asymptomatic bacteriuria

Urinary matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 biomarkers for predicting renal scar in children with urinary tract infection

Prognostic value of serum and urine kidney injury molecule-1 in infants with urinary tract infection

Contact Info

Product

Resources

About