Abstract
Background. The aim of this study was to examine the novel renal biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) to assist pediatricians in the assessment of longer duration of inflammation and acute kidney injury (AKI) development during urinary tract infection (UTI). Methods. The patients enrolled in the study comprised 50 children (mean age was 6 months) with UTI. NGAL in serum and urine (sNGAL and uNGAL, resp.) and KIM-1 in urine were measured by enzyme-linked immunosorbent assays. Results. uNGAL levels in subjects with longer duration of inflammation were higher (115.37 ng/mL) than uNGAL levels in subjects with shorter duration of inflammation (67.87 ng/mL, P = 0.022). Difference in sNGAL and KIM-1 levels was not significant (P = 0.155 and P = 0.198, resp.). Significant difference was seen in KIM-1 excretion among groups with and without AKI (P = 0.038). KIM-1 was not able to discriminate between subjects with and without AKI (area under the curves (AUC) = 0.620, P = 0.175). Conclusions. uNGAL cannot be used for screening of the duration of inflammation during UTI. Accuracy of KIM-1 in screening of AKI development in children with UTI is low. We suggest larger studies to check the negative predictive value of KIM-1 for the development of AKI.
Highlights
Urinary tract infection (UTI) is one of the most common infectious diseases encountered by pediatric healthcare providers [1]
Correlation coefficients for each parameter in younger and older subjects when measured at the time of admission to the hospital and at the time of hospital discharge were significant for urine level of neutrophil gelatinase-associated lipocalin (uNGAL) in younger subjects (r = 0.736, P < 0.001) and for Serum level of neutrophil gelatinase-associated lipocalin (sNGAL) in older subjects (r = 0.786, P = 0.036)
Our findings suggest that uNGAL is suitable for early diagnosis of urinary tract infection (UTI), it cannot be used for screening of the duration of inflammation during UTI or the severity of the illness
Summary
Urinary tract infection (UTI) is one of the most common infectious diseases encountered by pediatric healthcare providers [1]. More severe forms of UTI may cause acute complications. Children with UTI may develop a prerenal type of acute kidney injury (AKI) as a result of renal hypoperfusion due to severe dehydration. The cause of AKI in children with UTI may be of a renal origin, but significantly lower. The aim of this study was to examine the novel renal biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) to assist pediatricians in the assessment of longer duration of inflammation and acute kidney injury (AKI) development during urinary tract infection (UTI). Difference in sNGAL and KIM-1 levels was not significant (P = 0.155 and P = 0.198, resp.). Accuracy of KIM-1 in screening of AKI development in children with UTI is low. We suggest larger studies to check the negative predictive value of KIM-1 for the development of AKI
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