title: Predictive value of urinary and serum biomarkers in young children with febrile urinary tract infections.
abstract: BACKGROUND
  Early predictive biomarkers for the diagnosis and management of febrile urinary tract infections (UTIs) can be valuable diagnostic tools in children.
  
  
  METHODS
  The study cohort comprised 73 pediatric patients with febrile UTIs [46 with acute pyelonephritis (APN) and 27 with lower UTIs] and 56 healthy children. Urine neutrophil gelatinase-associated lipocalin (uNGAL) and kidney injury molecule-1 (uKIM-1) levels and serum cystatin C (sCysC) levels were measured.
  
  
  RESULTS
  The uNGAL/creatinine (Cr) and uKIM-1/Cr levels were higher in the UTI group than in the controls (P < 0.05). uNGAL/Cr and sCysC levels were higher in patients with APN than in those with lower UTIs (P < 0.05). uNGAL/Cr levels in both the APN and UTI groups decreased following the administration of antibiotics compared to those before treatment (P < 0.05). The uNGAL/Cr level was correlated with serum levels of white blood cells, C-reactive protein, CysC and with uKIM-1/Cr (P < 0.05). uKIM-1/Cr was also correlated with sCysC (P < 0.05). Receiver operating curve analyses showed good diagnostic profiles of uNGAL/Cr and uKIM-1/Cr for identifying UTIs [area under the curve (AUC) 0.9 and 0.66, respectively) and of uNGAL/Cr and sCysC for predicting APN (AUC 0.78 and 0.72, respectively).
  
  
  CONCLUSIONS
  Our results suggest that uNGAL, uKIM-1 and sCysC levels may be useful for predicting and managing febrile UTIs in children.
authors.affiliation: Department of Pediatrics, College of Medicine, Korea University, Seoul, South Korea, he-yim@hanmail.net.
authors.forename: Hyung Eun
authors.initials: HE
authors.lastname: Yim
authors.forename: Hyungshin
authors.initials: H
authors.lastname: Yim
authors.forename: Eun Soo
authors.initials: ES
authors.lastname: Bae
authors.forename: Sang Uk
authors.initials: SU
authors.lastname: Woo
authors.forename: Kee Hwan
authors.initials: KH
authors.lastname: Yoo
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine; D015415:Biomarkers / Q000097:blood* / Q000652:urine*; D016022:Case-Control Studies; D002675:Child, Preschool; D015331:Cohort Studies; D055316:Cystatin C / Q000652:urine; D005260:Female; D005334:Fever / Q000097:blood* / Q000652:urine*; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007223:Infant; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine; D008297:Male; D008562:Membrane Glycoproteins / Q000652:urine; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000652:urine; D011704:Pyelonephritis / Q000097:blood / Q000652:urine; D011991:Receptors, Virus; D014552:Urinary Tract Infections / Q000097:blood* / Q000175:diagnosis / Q000652:urine*; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000209:etiology
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D055316:Cystatin C; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D008562:Membrane Glycoproteins; D011518:Proto-Oncogene Proteins; D011991:Receptors, Virus