title: Urinary neutrophil gelatinase-associated lipocalin (NGAL) might be an independent marker for anticipating scar formation in children with acute pyelonephritis.
abstract: BACKGROUND
  Urinary tract infections (UTIs) are the most serious common bacterial infections among young children. It may affect kidneys that classified as acute pyelonephritis (APN) and may lead to renal parenchymal involvement and scarring with high prevalence rate (15%-60%) among children. This study aimed to assess the urinary concentration of neutrophil gelatinase-associated lipocalin (NGAL) in patients with APN to diagnose those with potency to scar formation.
  
  
  METHODS
  Children who were admitted with a diagnosis of APN were enrolled and divided into two groups; APN with scar and APN without scar. Urinary levels of NGAL and its ratio to creatinine (Cr) levels were measured in the acute phase of infection. A receiver operating characteristic (ROC) curve was generated to allow calculation of cut-off values.
  
  
  RESULTS
  Fifty-four children were enrolled across the 2 groups: group 1 consisted of 16 patients (all female); group 2 consisted of 38 children (36 female and 2 male). Urinary levels of NGAL were significantly higher in APN with scar than in APN without scar (P = 0.037). For comparison of groups 1 and 2, the cut-off values were measured as 7.32 ng/ml, sensitivity; 81.3% and specificity; 66%.
  
  
  CONCLUSIONS
  Evaluation of urinary NGAL levels may help us to identify children with APN who are at risk of developing renal scarring.
authors.affiliation: Molecular and Cell Biology Research Center, Department of Immunology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Rafiei
authors.affiliation: Antimicrobial Resistant Nosocomial Infection Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Mohammadjafari
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Bazi
authors.affiliation: Department of Immunology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Araz Mohammad
authors.initials: AM
authors.lastname: Mirabi
keywords: Acute pyelonephritis; NGAL; Scar; Urinary tract infection