title: Can procalcitonin reduce unnecessary voiding cystoureterography in children with first febrile urinary tract infection?
abstract: OBJECTIVE
  Recently, new predictors of vesicoureteral reflux (VUR) in children with a first febrile UTI such as Procalcitonin (PCT) were introduced as selective approaches for cystography. This study wants to show the capability of PCT in predicting presence of VUR at the first febrile UTI in children.
  
  
  METHODS
  Patients between 1 month and 15 years of age with febrile UTI were included in this prospective study. PCT values were measured through a semi-quantitative method in four grades comprising values less than 0.5, 0.5-2.0, 2.0-10.0 and above 10.0 ng/ml. The independence of PCT levels in predicting VUR were assessed after adjustment for all potential confounders using a logistic-regression model.
  
  
  RESULTS
  A total of 68 patients, 54 (79.4%) girls and 14 (20.6%) boys were evaluated. PCT level demonstrated a significant difference between patients with positive VUR and those with negative VUR (P=0.012). To calculate the independent factors that may predict the presence of VUR, all included variables were adjusted for age and sex. Results of logistic regression showed that a PCT level between 2.0 and 10.0 ng/mL could independently predict presence of VUR (Odds ratio=6.11, CI 95%= 1.22-30.77, P=0.03).
  
  
  CONCLUSIONS
  Our finding in this study showed that readily available semi-quantitative measures for PCT are feasible for detecting patients with VUR. We suggest that in semi-quantitative measurements of PCT, levels between 2.0 and 10.0 ng/ml could be an independent predictor of positive VUR.
authors.affiliation: Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Aliasghar
authors.initials: A
authors.lastname: Halimi-Asl
authors.affiliation: Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Amir Hossein
authors.initials: AH
authors.lastname: Hosseini
authors.affiliation: Department of Pediatrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Pooneh
authors.initials: P
authors.lastname: Nabavizadeh
keywords: Procalcitonin Levels; Urinary Tract Infection; Vesicoureteral Reflux; Voiding Cystourethrogram