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Procalcitonin and pyelonephritis in children
Paolo Pecile1, Carla Romanello
1Department of Pediatrics, University of Udine, Italy. paolo.pecile@uniud.it
Insights
Procalcitonin is a valuable biomarker for detecting kidney involvement in febrile urinary tract infections, offering better accuracy than C-reactive protein. This marker may help identify children at risk for complications and guide follow-up care.
Area of Science:
- Biochemistry
- Pediatrics
- Infectious Diseases
Background:
- Procalcitonin is an established inflammatory marker used in various medical fields.
- Recent research explores its utility in identifying renal involvement in febrile urinary tract infections (UTIs).
Purpose of the Study:
- To evaluate procalcitonin as a marker for renal involvement in febrile UTIs.
- To compare procalcitonin's diagnostic accuracy with C-reactive protein for pyelonephritis.
Main Methods:
- Literature review of studies investigating procalcitonin in febrile UTIs.
- Analysis of procalcitonin's sensitivity and specificity in predicting renal involvement.
Main Results:
- Procalcitonin demonstrates acceptable sensitivity and specificity for predicting pyelonephritis.
- It shows higher specificity compared to C-reactive protein for renal involvement.
- Procalcitonin levels correlate with the severity of infection and potential scarring.
Conclusions:
- Procalcitonin shows promise as a noninvasive tool for diagnosing renal involvement in febrile UTIs.
- Further studies are needed to confirm its role in identifying children at risk for complications and guiding management.
- Early identification of at-risk children can lead to closer follow-up and potentially prevent long-term sequelae.
Purpose Of Review:
In the past few years, procalcitonin has been proposed as a sensitive and specific inflammatory marker in various fields of medicine, especially in infectivology, where it has been used to discriminate between bacterial infections, viral infections and inflammation processes. Recently, different studies have emerged in the literature on the use of this marker to identify renal involvement in febrile urinary tract infections.
Recent Findings:
Procalcitonin seems to be a valid biological marker, with an acceptable sensitivity and specificity, which predicts a renal involvement of the infection (pyelonephritis), in comparison with the low specificity of C-reactive protein. Procalcitonin also seems to be correlated with the degree of the involvement at the moment of diagnosis of febrile urinary tract infections and with scarring.
Summary:
Renal involvement has always been the main diagnostic objective in children with febrile urinary tract infections. If more studies confirm the correlation between procalcitonin, renal involvement during urinary infections and scar formation, we will finally have a noninvasive tool that can identify children at risk of complications and in need of a close follow-up as early as their first episode of febrile urinary tract infection.
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