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[Evaluation of inflammatory and renal injury markers in youngest children with pyelonephritis]

Alina Puczko-Michalczuk1, Walentyna Zoch-Zwierz, Anna Wasilewska

  • 1Uniwersytet Medyczny w Białymstoku, Klinika Pediatrii i Nefrologii.

Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego
|February 12, 2009
PubMed

Insights

Procalcitonin (PCT) and tumor necrosis factor alpha (TNF-alpha) are valuable biomarkers for early pyelonephritis (PN) diagnosis in infants. These markers offer higher sensitivity and specificity than C-reactive protein (CRP) for prompt bacterial infection identification.

Area of Science:

  • Pediatric infectious diseases
  • Biomarker research
  • Renal medicine

Background:

  • Pyelonephritis (PN) is a common bacterial infection in infants, potentially leading to renal scarring.
  • Early diagnosis and treatment are crucial to prevent long-term kidney damage.

Purpose of the Study:

  • To assess the utility of serum procalcitonin (PCT), tumor necrosis factor alpha (TNF-alpha), and urinary alpha1-microglobulin (A1M) as inflammatory and renal injury markers.
  • To compare these markers against C-reactive protein (CRP) for diagnosing pyelonephritis in neonates and young infants.

Main Methods:

  • Investigated two groups: 23 infants with PN and 30 healthy infants (1-24 weeks old).
  • Measured serum CRP, PCT, TNF-alpha, and urinary A1M using various assay methods (immunonephelometry, immunoluminometry, ELISA, nephelometry).

Main Results:

  • Elevated PCT, TNF-alpha, A1M, and CRP levels were observed in PN patients before treatment.
  • PCT and TNF-alpha demonstrated high sensitivity and specificity (PCT: 81.8%/87.2%, TNF-alpha: 77.1%/93.1%) for identifying bacterial infections.
  • Positive correlations were found between PCT, CRP, and TNF-alpha; higher marker concentrations were noted in infants with vesicoureteral reflux or hydronephrosis.

Conclusions:

  • PCT and TNF-alpha are more valuable than CRP for the early diagnosis of pyelonephritis in young infants.
  • These biomarkers aid in the rapid identification of bacterial infections, even before urine culture results are available.
Abstract

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