Role of beta 2-microglobulinuria and microalbuminuria in pediatric febrile urinary tract infection.
Urinary beta-2-microglobulin (beta 2M) and microalbumin concentrations were analyzed in 61 pediatric patients with febrile urinary tract infection (UTI). The results were compared with those of technetium-99m-labeled dimercaptosuccinic acid (99mTc-DMSA) single photon emission computed tomography (SPECT) imaging. Noninvasive evaluations were made to localize the site of the UTI. Increased urinary beta 2M/Creatinine (Cr) or microalbumin/Cr quotients were not associated with renal inflammation, as defined by a positive renal scan. Increased urinary microalbumin/Cr is associated with UTI in febrile patients regardless of the level of infection (scan status), and may be an informative indicator of UTI. When microalbumin/Cr was > or = 0.03, its sensitivity and specificity to predict UTI in febrile patients, regardless of the site of the infection, were 95.65% and 51.79%, respectively, and its positive predictive value was 62.0%. On the other hand, urinary beta 2M/Cr (> or = 0.13) demonstrates a statistically significant correlation with the presentation of a high grade of vesicoureteral reflux (p = 0.02). We suggest that a prompt renal imaging study is warranted when the urinary beta 2M/Cr ratio is high (> or = 0.13).
Chiou
Y Y
YY
Department of Pediatrics, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan. yuanyow@mail.ncku.edu.tw
Chiu
N T
NT
Chen
M J
MJ
Cheng
H L
HL
D000419:Albuminuria / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D015899:Tomography, Emission-Computed, Single-Photon; D014552:Urinary Tract Infections / Q000150:complications*; D014718:Vesico-Ureteral Reflux / Q000209:etiology; D001613:beta 2-Microglobulin / Q000652:urine*
D001613:beta 2-Microglobulin; D019783:Technetium Tc 99m Dimercaptosuccinic Acid