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Pediatric Nephrology

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01-03-2017 | Original Article

Plasma neutrophil gelatinase-associated lipocalin: a marker of acute pyelonephritis in children

Authors: Byung Kwan Kim, Hyung Eun Yim, Kee Hwan Yoo

Published in: Pediatric Nephrology | Issue 3/2017

Abstract

Objectives

This study was designed to compare the diagnostic accuracy of plasma neutrophil gelatinase-associated lipocalin (NGAL) with procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBCs) for predicting acute pyelonephritis (APN) in children with febrile urinary tract infections (UTIs).

Materials and methods

In total, 138 children with febrile UTIs (APN 59, lower UTI 79) were reviewed retrospectively. Levels of NGAL, PCT, CRP, and WBCs in blood were measured on admission. The diagnostic accuracy of the biomarkers was investigated. Independent predictors of APN were identified by multivariate logistic regression analysis.

Results

Receiver operating curve (ROC) analyses showed good diagnostic profiles of NGAL, PCT, CRP, and WBCs for identifying APN [area under the curve (AUC) 0.893, 0.855, 0.879, and 0.654, respectively]. However, multivariate analysis revealed only plasma NGAL level was an independent predictor of APN (P = 0.006). At the best cutoff values of all examined biomarkers for identifying APN, sensitivity (86 %), specificity (85 %), positive predictive value (81 %), and negative predictive value (89 %) of plasma NGAL levels were the highest. The optimal NGAL cutoff value was 117 ng/ml. The positive likelihood ratio [odds ratio (OR) 5.69, 95 % confidence interval (CI) 3.56–8.78], and negative likelihood ratio (OR 0.16, 95 % CI 0.08-0.29) of plasma NGAL for APN diagnosis also showed it seemed to be more accurate than serum PCT, CRP, and WBCs.

Conclusion

Plasma NGAL can be more useful than serum PCT, CRP, and WBC levels for identifying APN in children with febrile UTIs.

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Title: Plasma neutrophil gelatinase-associated lipocalin: a marker of acute pyelonephritis in children
Authors: Byung Kwan Kim
Hyung Eun Yim
Kee Hwan Yoo
Publication date: 01-03-2017
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 3/2017
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-016-3518-y

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Springer Medicine

Plasma neutrophil gelatinase-associated lipocalin: a marker of acute pyelonephritis in children

Abstract

Objectives

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

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