title: Predictive factors for kidney damage in febrile urinary tract infection. Usefulness of procalcitonin.
abstract: OBJECTIVE
  To establish the utility of procalcitonin (PCT) and other clinical and analytical parameters as markers of acute and permanent renal damage in children after a first febrile urinary tract infection (UTI).
  
  
  METHODS
  Retrospective multicentre study. Statistical study: descriptive, receiver operating characteristic (ROC) curves and multiple logistic regression.
  
  
  RESULTS
  219 patients, aged between 1 week and 14 years (68% under 1 year). The mean PCT values were significantly higher in patients with acute pyelonephritis with respect to normal acute DMSA (4.8 vs 1.44; p=0.0001), without achieving that signification for late affected DMSA (6.5 vs 5.05; p=0.6). The area under the ROC curve for PCT was 0.64 (CI 95% 0.55-0.72) for acute renal damage, and 0.62 (CI 95% 0.44-0.80) for permanent damage, with optimum statistical cut-off values of 0.85 and 1.17ng/ml. Multivariate analysis for acute renal damage only found correlation with PCT (Odds Ratio [OR] 1.2 (CI 95% 1.06-1.4, p=0.005), and hours of fever (OR for less than 6 hours of fever 0.4 (CI 95% 0.2-1.02, p=0.05). In patients with renal scarring, PCT showed an OR 1.0 (CI 95% 0.9-1.1, p=0.6).
  
  
  CONCLUSIONS
  PCT and the duration of fever were the only parameters statistically associated with early renal damage. PCT and renal scarring did not reach statistical significance.
authors.forename: Elena
authors.initials: E
authors.lastname: Lucas-Sáez
authors.forename: Susana
authors.initials: S
authors.lastname: Ferrando-Monleón
authors.forename: Juan
authors.initials: J
authors.lastname: Marín-Serra
authors.forename: Ricardo
authors.initials: R
authors.lastname: Bou-Monterde
authors.forename: Jaime
authors.initials: J
authors.lastname: Fons-Moreno
authors.forename: Amelia
authors.initials: A
authors.lastname: Peris-Vidal
authors.forename: Aurelio
authors.initials: A
authors.lastname: Hervás-Andrés
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000150:complications; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000097:blood* / Q000209:etiology*; D008297:Male; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000097:blood* / Q000150:complications*
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide