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Elevated Urinary Hepcidin Level and Hypoferremia in Infants with Febrile Urinary Tract Infection: A Prospective

Yu-Chen Hsu1, Hsin-Chun Huang1,2, Kuo-Su Tang1

  • 1Department of Pediatrics, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung 83301, Taiwan.

Children (Basel, Switzerland)
|May 27, 2023
PubMed

Insights

Febrile urinary tract infections (UTIs) in infants elevate urinary hepcidin-creatinine ratio, a marker that significantly decreases after antibiotic treatment, particularly for E. coli infections.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Nephrology

Background:

  • Febrile urinary tract infections (UTIs) are common in infants.
  • Hepcidin plays a role in iron homeostasis and inflammation.
  • Urinary hepcidin-creatinine ratio as a biomarker in pediatric infections is under investigation.

Purpose of the Study:

  • To investigate the kinetics of serum and urinary hepcidin levels in infants with febrile UTI.
  • To correlate hepcidin levels with anemia-related parameters during infection and treatment.
  • To compare findings between E. coli and non-E. coli UTIs.

Main Methods:

  • Prospective study of febrile infants aged 1-4 months with UTI.
  • Categorization into E. coli and non-E. coli UTI groups.
  • Collection of serum hepcidin, iron profile, and urinary hepcidin-creatinine ratio at admission and post-antibiotic treatment.

Main Results:

  • Febrile UTI infants showed reduced serum iron and elevated urinary hepcidin-creatinine ratio on admission.
  • Urinary hepcidin-creatinine ratio was a significant predictor (OR 2.01) of UTI.
  • Hemoglobin and urinary hepcidin-creatinine ratio decreased significantly after 3 days of antibiotics, especially in E. coli UTI.

Conclusions:

  • Urinary hepcidin-creatinine ratio is elevated during acute febrile UTI in infants.
  • This ratio decreases significantly after antibiotic therapy, indicating resolution of inflammation.
  • The response of urinary hepcidin-creatinine ratio to treatment differs between E. coli and non-E. coli UTIs.

Keywords:
hemoglobinhepcidinironurinary tract infectionurine

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