656 THE APPLICATION OF URINARY BIOMARKERS TO THE DIAGNOSIS OF FEBRILE URINARY TRACT INFECTION AND THE PREDICTION OF SUBSEQUENT SCARRING IN YOUNG CHILDREN LESS THAN 4 YEARS OLD

You have accessJournal of UrologyPediatrics: Urinary Tract Infection/Vesicoureteral Reflux1 Apr 2013656 THE APPLICATION OF URINARY BIOMARKERS TO THE DIAGNOSIS OF FEBRILE URINARY TRACT INFECTION AND THE PREDICTION OF SUBSEQUENT SCARRING IN YOUNG CHILDREN LESS THAN 4 YEARS OLD Kwanjin Park, Han Ey Lee, Min Ki Baek, and Hwang Choi Kwanjin ParkKwanjin Park Seoul, Korea, Republic of More articles by this author , Han Ey LeeHan Ey Lee Seoul, Korea, Republic of More articles by this author , Min Ki BaekMin Ki Baek Seoul, Korea, Republic of More articles by this author , and Hwang ChoiHwang Choi Sungnam, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.209AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urine biomarkers for acute renal injury may be helpful in diagnosing febrile urinary tract infection (UTI) and predicting subsequent scarring due to non-invasiveness and specificity for renal injury. We prospectively assessed the feasibility of 2 urinary markers of renal injury as potential diagnostic tests for acute febrile UTI. METHODS This study enrolled 0-4 year aged children who had visited emergency room. They were divided into 3 groups: febrile UTI group (fUTI), non-febrile UTI group (nfUTI) and normal control (C). They were equally matched with sex and age within 6 months. fUTI was diagnosed based on clinical findings, urinalysis, serum CRP and DMSA. ELISA for neutrophil gelatinase associated lipocalin (NGAL) and kidney injury molecule -1 (KIM-1) was performed with collected urine. We compared urine levels of both markers among groups and determined diagnostic accuracy represented by area under curve (AUC) in Receiver-Operator Curve (ROC). In fUTI group, the predictability of renal scarring was assessed by associating their urinary levels with findings of DMSA after 6 months of UTI. RESULTS Compared to the other groups, significantly elevated level of NGAL and KIM-1 were observed in fUTI. Increased levels of both markers were associated with positive finding of both urine esterase and pyuria. Also both markers were correlated with serum level of CRP. The AUC revealed 72% for KIM-1 and 96% for NGAL. Significantly higher levels of KIM-1 were noted in those presented subsequent scarring. The AUC for KIM-1 was 82%. CONCLUSIONS The diagnosis of febrile UTI and the prediction of subsequent scarring may be helped by assaying urine biomarkers with acceptable accuracy. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e268 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.Metrics Author Information Kwanjin Park Seoul, Korea, Republic of More articles by this author Han Ey Lee Seoul, Korea, Republic of More articles by this author Min Ki Baek Seoul, Korea, Republic of More articles by this author Hwang Choi Sungnam, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...