Early prediction of renal parenchymal injury with serum procalcitonin.
BACKGROUND
Urinary tract infection (UTI) is one of the most common bacterial infections in children that can be associated with renal parenchymal injuries and late scars. Dimercaptosuccinic acid (DMSA) renal scan is known as golden standard for detecting acute pyelonephritis (APN) that has a lot of difficulties and limitations.


OBJECTIVE
we designed this study the accuracy of one inflammatory marker, serum procalcitonin (PCT) to identify as an early predictor of renal injuries.


METHODS
A prospective study was carried out in 95 patients who admitted in the hospital with the first febrile UTI. Serum PCT of all patients was measured; sensitivity, specificity, positive and negative predictive value (PPV and NPV) of this marker was analyzed compared to DMSA scan. P value <0.05 was taken as significant.


RESULTS
In total, 79 females and 16 males were investigated. There are 42 cases in group 1 with normal DMSA scan and 53 patients in group two with renal parenchymal injuries in their scans. Mann-Whitney test showed a meaningful relation between the two groups regarding PCT level (P<0.0001). Sensitivity, specificity, PPV and NPV of PCT reported in optimum cut off were 70%, 88.1%, 88.1% and 70%, respectively. The positive likelihood ratio (PLR) of PCT test was 5.8.


CONCLUSIONS
In the current survey, PCT was the eligible inflammatory marker to predict renal parenchymal injuries in children with proper sensitivity, specificity, PPV and NPV that play also a pivotal role in the children aged less than 24 months, although, more studies should be undertaken to confirm.
Neonatal and Children's Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Leila
L
Barati
Neonatal and Children's Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Baranak
B
Safaeian
Neonatal and Children's Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Mahshid
M
Mehrjerdian
Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
Mohammad-Ali
MA
Vakili
Children; Procalcitonin; Urinary tract infection
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