title: Diagnostic value of serum procalcitonin for acute pyelonephritis in infants and children with urinary tract infections: an updated meta-analysis.
abstract: OBJECTIVE
  The aims were to assess (1) the diagnostic value of serum procalcitonin (PCT) for acute pyelonephritis (APN) in infants and children with urinary tract infections (UTIs) and (2) to compare the performance of two commonly used cutoff values.
  
  
  METHODS
  A meta-analysis of serum PCT in the diagnosis of APN among pediatrics with lower UTIs was conducted. The process of search strategy, publications selection and data analysis was in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines.
  
  
  RESULTS
  Eighteen high-quality studies with a total of 831 APN patients and 651 individuals with lower UTIs were analyzed. The overall performance of serum PCT ≥ 0.5 ng/mL was as follows: pooled sensitivity of 0.86 (95 % CI 0.73-0.93), pooled specificity of 0.76 (95 % CI 0.66-0.83), DOR of 18.90 (95 % CI 6.78-52.71) and AUROC of 0.86 (95 % CI 0.83-0.89), with significant heterogeneity. However, use of 1.0 ng/mL as a cutoff value produced an improved specificity of 0.91 (95 % CI 0.86-0.94), a DOR of 55.06 (95 % CI 22.57-115.48) and an AUROC of 0.94 (95 % CI 0.92-0.96), without obvious heterogeneity.
  
  
  CONCLUSIONS
  In pediatrics with UTIs, the cutoff value of serum PCT, 1.0 ng/mL, has a preferable diagnostic performance compared with 0.5 ng/mL for APN. Additional prospective studies that propose an appropriate cutoff value and validate the performance of PCT for young with APN are needed in the future.
authors.affiliation: Department of Nephrology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Huhai
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Nephrology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jurong
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Nephrology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Lirong
authors.initials: L
authors.lastname: Lin
authors.affiliation: Department of Nephrology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Bengang
authors.initials: B
authors.lastname: Huo
authors.affiliation: Department of Nephrology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Huanzi
authors.initials: H
authors.lastname: Dai
authors.affiliation: Department of Nephrology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, China. heyani1966@163.com.
authors.forename: Yani
authors.initials: Y
authors.lastname: He
mesh_terms: D000208:Acute Disease; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011379:Prognosis; D011704:Pyelonephritis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D014552:Urinary Tract Infections / Q000097:blood / Q000150:complications* / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D002116:Calcitonin
keywords: Acute pyelonephritis; Diagnosis; Procalcitonin; Urinary tract infections