C-reactive Protein is a Useful Marker to Predict the Severity and Early Response of Acute Pyelonephritis in Women

Abstract

Purpose: To evaluate the values of C-reactive proteins (CRP) for predicting the severity and results of treatment for acute pyelonephritis in women, we compared the severity of symptoms and signs, the laboratory findings and the initial serum CRP according to the early response to treatment. Materials and Methods: We retrospectively analyzed 298 female patients who were diagnosed with acute uncomplicated pyelonephritis between January 2002 and Match 2007. All the medical records were reviewed for a variety of factors, and the baseline characteristics and CRP level were compared between the patients with an early response to treatment and those without according to the 3rd hospital day urine analysis. Results: The initial white blood cell (WBC) counts, the CRP level, the neutrophil ratio and severity of symptoms were significantly higher in the delayed response groups than those in the early response groups. The age, history of previous pyelonephritis, symptom duration, body mass index (BMI), and the number of positive blood and urine cultures were not different between the two groups. According to the results of the multivariate logistic regression analysis, the CRP level, neutrophil ratio and mild symptoms were independent predictive variables that affected the delayed response. The odds ratios (95% CI) were 1.078 (1.028-1.131) for the CRP, 1.030 (1.001-1.060) for the neutrophil ratio and 9.268 (1.07280.166) for the severe symptoms. The differences between the areas under the ROC curves for CRP and the WBC counts and for the CRP level and neutrophil ratio were statistically significant (p<0.001 and p<0.05, respectively). Conclusions: We found that the discriminatory power of the initial CRP level was high with regard to predicting an early response. So, we were able to determine a CRP level that would be useful in guiding hospitalization. (Korean J Urol 2007;48:1143-1148) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏