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Procalcitonin implication in renal cell apoptosis induced by acute pyelonephritis in children

Hafid Belhadj-Tahar1, Yvon Coulais, Mathieu Tafani

  • 1Groupe Santé Recherche, Toulouse, France;

Infection and Drug Resistance
|June 23, 2011
PubMed

Insights

Procalcitonin (PCT) levels in children with acute pyelonephritis were studied. Lower PCT correlated with renal fibrosis, suggesting PCT may protect against kidney damage.

Area of Science:

  • Biomedical research
  • Pediatric nephrology
  • Clinical trial

Background:

  • Acute pyelonephritis is a common childhood kidney infection.
  • Understanding the role of biomarkers like procalcitonin (PCT) in disease progression is crucial.
  • Renal parenchyma apoptosis and fibrosis are significant complications of pyelonephritis.

Purpose of the Study:

  • To investigate the physiological role of procalcitonin (PCT) in pediatric acute pyelonephritis.
  • To determine the association between PCT levels and renal parenchyma apoptosis and fibrosis.
  • To explore PCT's potential protective effects in kidney injury.

Main Methods:

  • Prospective study of 183 children with acute pyelonephritis.
  • Treatment included intravenous ceftriaxone and netilmicin, followed by tailored antibiotics.
  • Serum PCT, C-reactive protein, and phospholipase A2 were measured. Renal scintigraphy ((99m)Tc-DMSA) was performed on day 4 and 9 months later.

Main Results:

  • 78% of children showed renal parenchyma alterations on day 4; 30% developed renal fibrosis at 9 months.
  • Paradoxically, lower PCT levels were observed in cases with renal fibrosis due to apoptosis (4.19 vs 7.59 μg/L).
  • Increased PCT levels correlated with favorable outcomes (recovery: 7.55 vs aggravation: 3.34 μg/L).

Conclusions:

  • Procalcitonin may have a protective role against apoptosis in acute pyelonephritis.
  • PCT levels appear to be a significant indicator of disease progression and outcome.
  • The findings suggest PCT down-regulates nitric oxide, potentially mitigating renal damage.

Keywords:
acute pyelonephritisapoptosisfibrosisprocalcitonintechnetium-DMSA

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