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Urine neutrophil gelatinase-associated lipocalin and other biomarkers in infants with urinary tract infection and in febrile controls

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Abstract

Background

Urine biomarkers are commonly used in the evaluation of acute kidney injury, and are gaining attention as tools for studying urinary tract infections (UTIs). We analyzed neutrophil gelatinase-associated lipocalin (NGAL) and seven other urine biomarkers to evaluate their usefulness in the diagnosis of UTI in infants.

Methods

Eight urine biomarkers were analyzed in 108 infants with UTI. Controls were 64 febrile children without UTI and 13 healthy children. Logistic regression and construction of receiver operating characteristic (ROC) curves were performed for UTI patients versus febrile controls for all biomarkers.

Results

The best biomarkers to differentiate between UTI and febrile controls were NGAL and interleukin 8 (IL8). Urine NGAL in absolute concentration and adjusted for creatinine had a sensitivity of 93% and 96% and a specificity of 95% and 100% for diagnosing UTI, with a cut-off concentration of 38 ng/mL and 233 ng/mg respectively.

Conclusions

Urine biomarkers, particularly NGAL, can aid in the diagnosis of UTI among febrile infants. The results suggest that in infants with fever and high NGAL, UTI is most likely, whereas in infants with fever and low NGAL, other causes of fever should be looked for.

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Acknowledgements

We thank Aldina Pivodic for help with statistical analysis and Tina Linnér for coordination. The study was supported by the Swedish Government under the agreement between the Government and the County Councils concerning economic support of medical research and education (the ALF agreement), and by the Queen Silvia Children’s Hospital Research Foundation.

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Authors and Affiliations

  1. Department of Pediatrics, Sahlgrenska University Hospital, Sahlgrenska Academy, Gothenburg, Sweden

    Sindri Valdimarsson, Ulf Jodal & Sverker Hansson

  2. The Queen Silvia Children’s Hospital, 416 85, Gothenburg, Sweden

    Sindri Valdimarsson

  3. Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Gothenburg, Sweden

    Lars Barregård

Authors
  1. Sindri Valdimarsson
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  2. Ulf Jodal
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  3. Lars Barregård
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  4. Sverker Hansson
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Correspondence to Sindri Valdimarsson.

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The authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by the Regional Ethical Review Board in Gothenburg (372–10). All examinations were conducted after obtaining written informed consent from the parents.

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Valdimarsson, S., Jodal, U., Barregård, L. et al. Urine neutrophil gelatinase-associated lipocalin and other biomarkers in infants with urinary tract infection and in febrile controls. Pediatr Nephrol 32, 2079–2087 (2017). https://doi.org/10.1007/s00467-017-3709-1

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  • DOI: https://doi.org/10.1007/s00467-017-3709-1

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