Urinary proteins in children with urinary tract infection.
The aim of this study was to test our hypothesis that the urinary excretion of C-reactive protein (CRP), alpha 1-microglobulin (A1M), retinol-binding protein (RBP) and Clara cell protein (CC16) is increased in children with urinary tract infection (UTI) and relates to renal damage as measured by acute dimercaptosuccinic acid (DMSA) scintigraphy. Fifty-two children <2 years of age with UTI were enrolled in the study, 44 of whom were febrile. The control group consisted of 23 patients with non-UTI infection and elevated serum CRP (s-CRP) levels. Thirty-six patients had abnormal DMSA uptake, classified as mild, moderate or severe damage (DMSA class 1, 2, 3, respectively). There was a significant association between DMSA class and the excretion of urinary RBP (u-RBP) and u-CC16. There was also a significant difference in u-CRP levels between children with UTI and control children with non-UTI infections, although u-CRP excretion was not significantly correlated to DMSA class. In conclusion, the urinary excretion of the low-molecular-weight proteins RBP and CC16 showed a strong association with uptake defects on renal DMSA scans. The urinary level of CRP seems to distinguish between children with UTI and other febrile conditions. A combination of these biomarkers may be useful in the clinical assessment of children with UTI.
Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital and Academy, University of Gothenburg, P.O. Box 414, 405 30, Gothenburg, Sweden. lena.andersson@amm.gu.se
Lena
L
Andersson
Iulian
I
Preda
Mirjana
M
Hahn-Zoric
Lars A
LA
Hanson
Ulf
U
Jodal
Rune
R
Sixt
Lars
L
Barregard
Sverker
S
Hansson
D000510:Alpha-Globulins / Q000652:urine*; D002097:C-Reactive Protein / Q000652:urine*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012177:Retinol-Binding Proteins / Q000652:urine*; D014552:Urinary Tract Infections / Q000652:urine*; D014598:Uteroglobin / Q000652:urine*
D000510:Alpha-Globulins; D012177:Retinol-Binding Proteins; C556389:SCGB1A1 protein, human; C016001:alpha-1-microglobulin; D002097:C-Reactive Protein; D014598:Uteroglobin