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ePublished: 28 May 2016
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J Renal Inj Prev. 2016;5(3): 108-111.
doi: 10.15171/jrip.2016.23
PMID: 27689104
PMCID: PMC5039994
  Abstract View: 3343
  PDF Download: 1732

Original Article

Early prediction of renal parenchymal injury with serum procalcitonin  

Leila Barati 1, Baranak Safaeian 1*, Mahshid Mehrjerdian 1, Mohammad-Ali Vakili 2

1 Neonatal and Children’s Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
2 Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
*Corresponding Author: *Corresponding author: Baranak Safaeian, , Email: baranak54@yahoo.com

Abstract

Introduction: 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.

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

Patients and 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.

Conclusion: 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.

 

Implication for health policy/practice/research/medical education:

Urinary tract infection (UTI) may present with nonspecific symptoms and its accurate diagnosis is too difficult in cases with outpatient usage of antibiotic, furthermore, delay in diagnosis and treatment of UTI in children can due to more damages in renal parenchyma. Thus finding a rapid and reliable method is a necessity. PCT level can be determined by venous blood samples  that is generally available in hospitals, therefore we sought to study the value of serum procalcitonin (PCT) as an inflammatory marker in UTI.

Please cite this paper as: Barati L, Safaeian B, Mehrjerdian M, Vakili MA. Early prediction of renal parenchymal injury with serum procalcitonin. J Renal Inj Prev. 2016;5(3):108-111. DOI: 10.15171/jrip.2016.23

 
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