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Open Access 01-12-2021 | Pyelonephritis | Research article

MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children

Authors: Rafael Peñalver Penedo, Marta Rupérez Lucas, Luis Antonio Álvarez-Sala Walther, Alicia Torregrosa Benavent, María Luisa Casas Losada, Luis Bañuelos Andrio, Ana Belén Rebolledo Poves, Mercedes Bueno Campaña

Published in: BMC Pediatrics | Issue 1/2021

Abstract

Background

Midregional-proadrenomedullin (MR-proADM) is a useful prognostic peptide in severe infectious pathologies in the adult population. However, there are no studies that analyze its utility in febrile urinary tract infection (fUTI) in children. An accurate biomarker would provide an early detection of patients with kidney damage, avoiding other invasive tests like renal scintigraphy scans. Our objective is to study the usefulness of MR-proADM as a biomarker of acute and chronic renal parenchymal damage in fUTI within the pediatric population.

Methods

A prospective cohort study was conducted in pediatric patients with fUTI between January 2015 and December 2018. Plasma and urine MR-proADM levels were measured at admission in addition to other laboratory parameters. After confirmation of fUTI, renal scintigraphy scans were performed during the acute and follow-up stages. A descriptive study has been carried out and sensitivity, specificity and ROC curves for MR-proADM, C-reactive protein, and procalcitonin were calculated.

Results

62 pediatric patients (34 female) were enrolled. Scintigraphy showed acute pyelonephritis in 35 patients (56.5%). Of those patients, the median of plasmatic MR-proADM (P-MR-proADM) showed no differences compared to patients without pyelonephritis. 7 patients (11.3%) developed renal scars (RS). Their median P-MR-proADM levels were 1.07 nmol/L (IQR 0.66–1.59), while in patients without RS were 0.48 nmol/L (0.43–0.63) (p < 0.01). The AUC in this case was 0.92 (95% CI 0.77–0.99). We established an optimal cut-off point at 0.66 nmol/L with sensitivity 83.3% and specificity 81.8%.

Conclusion

MR-ProADM has demonstrated a poor ability to diagnose pyelonephritis in pediatric patients with fUTI. However, P-MR-proADM proved to be a very reliable biomarker for RS prediction.

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Title: MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children
Authors: Rafael Peñalver Penedo
Marta Rupérez Lucas
Luis Antonio Álvarez-Sala Walther
Alicia Torregrosa Benavent
María Luisa Casas Losada
Luis Bañuelos Andrio
Ana Belén Rebolledo Poves
Mercedes Bueno Campaña
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Pyelonephritis
Urinary Tract Infection
Scintigraphy
Pyelonephritis
Biomarkers
Published in: BMC Pediatrics / Issue 1/2021
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-021-02765-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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