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Elevated serum procalcitonin values correlate with renal scarring in children with urinary tract infection

Cristina Prat1, Josep Domínguez, Carlos Rodrigo

  • 1Serveis de Microbiologia, Hospital Universitari Germans Trias i Pujol, C/Canyet s/n, 08916 Badalona, Spain. crisprat@ns.hugtip.scs.es

The Pediatric Infectious Disease Journal
|June 7, 2003
PubMed

Insights

Procalcitonin (PCT) serum levels can predict long-term kidney scarring in children with urinary tract infections (UTIs). Low PCT indicates a low risk of scarring, while elevated levels correlate with renal damage, proving more specific than CRP.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Biomarker Research

Background:

  • Urinary tract infections (UTIs) in children risk kidney damage.
  • Differentiating lower UTI from acute pyelonephritis is challenging due to non-specific early symptoms.
  • Procalcitonin (PCT) is investigated as a marker for severe bacterial infections.

Purpose of the Study:

  • To evaluate serum procalcitonin (PCT) concentration for distinguishing uncomplicated UTI from acute pyelonephritis with renal scarring in children.
  • To assess PCT's utility in predicting long-term renal sequelae.

Main Methods:

  • Serum PCT levels were measured using immunoluminometric assay in children with confirmed UTIs.
  • Renal scarring was assessed 5-6 months post-infection using 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy.
  • C-reactive protein (CRP) and leukocyte count were also analyzed for comparison.

Main Results:

  • Serum PCT at presentation strongly correlated with the presence of renal scars (P < 0.001).
  • PCT demonstrated high sensitivity (92.3%) and better specificity (61.9%) than CRP (34.4%) in identifying renal damage.
  • PCT showed a high negative predictive value (97.5%) for renal scarring.

Conclusions:

  • Low admission PCT levels are associated with a reduced risk of long-term renal scarring.
  • Elevated PCT values at admission correlate with established renal scars.
  • PCT is a more specific biomarker than CRP and leukocyte count for identifying children at risk of developing renal damage from UTI.
Abstract

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