title: Plasma neutrophil gelatinase-associated lipocalin predicts acute pyelonephritis in children with urinary tract infections.
abstract: BACKGROUND
  The identification of acute pyelonephritis (APN) is still a challenge.
  
  
  METHODS
  Patients admitted for their ﬁrst urinary tract infection (UTI) were enrolled. Plasma neutrophil gelatinase-associated lipocalin (NGAL) levels were measured at admittance and after treatment. Laboratory, clinical, and imaging results were compared between children with and without APN.
  
  
  RESULTS
  A total of 123 patients were enrolled (53 APN and 70 lower UTI). After adjusting for age and gender, plasma NGAL levels were higher in the APN group than in the lower UTI group (233 (129-496) ng/ml vs. 71 (50.8-110) ng/ml, P < 0.001). NGAL levels were correlated with the serum levels of leukocytes, C-reactive protein, and creatinine, as well as fever duration (P < 0.05). Multivariable analysis revealed that log-transformed plasma NGAL was an independent predictor of APN (P < 0.05). Receiver operating curve analysis showed a good diagnostic profile of NGAL for identifying APN (area under the curve 0.864) with a best cut-off value of 102.5 ng/ml. The NGAL levels in both two groups decreased after treatment compared to levels before treatment (P < 0.001).
  
  
  CONCLUSIONS
  Plasma NGAL can be a sensitive predictor for identifying APN and monitoring the treatment response of pediatric UTI.
authors: Department of Pediatrics, College of Medicine, Korea University, Seoul, South Korea.
authors: Ji Hyun
authors: JH
authors: Sim
authors: Department of Pediatrics, College of Medicine, Korea University, Seoul, South Korea.
authors: Hyung Eun
authors: HE
authors: Yim
authors: Department of Pediatrics, College of Medicine, Korea University, Seoul, South Korea.
authors: Byung Min
authors: BM
authors: Choi
authors: Department of Pediatrics, College of Medicine, Korea University, Seoul, South Korea.
authors: Jee Hyun
authors: JH
authors: Lee
authors: Department of Pediatrics, College of Medicine, Korea University, Seoul, South Korea.
authors: Kee Hwan
authors: KH
authors: Yoo
mesh_terms: D000208:Acute Disease; D000209:Acute-Phase Proteins; D019540:Area Under Curve; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D007223:Infant; D007962:Leukocytes / Q000166:cytology; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008297:Male; D015999:Multivariate Analysis; D011518:Proto-Oncogene Proteins / Q000097:blood*; D011704:Pyelonephritis / Q000097:blood* / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D014552:Urinary Tract Infections / Q000097:blood* / Q000209:etiology
chemical_list: D000209:Acute-Phase Proteins; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D002097:C-Reactive Protein; D003404:Creatinine