Role of procalcitonin in predicting dilating vesicoureteral reflux in young children hospitalized with a first febrile urinary tract infection.

doi:10.1097/INF.0b013e3182905d83

中山醫學大學機構典藏 CSMUIR > 醫學院 > 醫學系 > 期刊論文 > Item 310902500/10460

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Title:	Role of procalcitonin in predicting dilating vesicoureteral reflux in young children hospitalized with a first febrile urinary tract infection.
Authors:	Sun, HL Wu, KH Chen, SM Chao, YH Ku, MS Hung, TW Liao, PF Lue, KH Sheu, JN
Contributors:	中山醫學大學
Keywords:	acute pyelonephritis;procalcitonin;dilating vesicoureteral reflux;febrile urinary tract infection;young children
Date:	2013-09
Issue Date:	2015-03-16T04:56:33Z (UTC)
ISSN:	0891-3668
Abstract:	Objective: The aim of this article was to assess the usefulness of procalcitonin (PCT) as a marker for predicting dilating (grades III–V) vesicoureteral reflux (VUR) in young children with a first febrile urinary tract infection. Methods: Children ≤2 years of age with a first febrile urinary tract infection were prospectively evaluated. Serum samples were tested for PCT at the time of admission to a tertiary hospital. All children underwent renal ultrasonography (US), 99mTc-dimercaptosuccinic acid renal scan, and voiding cystourethrography. The diagnostic characteristics of PCT test for acute pyelonephritis and dilating VUR were calculated. Results: Of 272 children analyzed (168 boys and 104 girls; median age, 5 months), 169 (62.1%) had acute pyelonephritis. There was VUR demonstrated in 97 (35.7%), including 70 (25.7%) with dilating VUR. The median PCT value was significantly higher in children with VUR than in those without (P < 0.001). Using a PCT cutoff value of ≥1.0 ng/mL, the sensitivity and negative predictive value for predicting dilating VUR were 94.3% and 95.4%, respectively, for PCT, and 97.1% and 97.8%, respectively, for the combined PCT and US studies, whereas the positive and negative likelihood ratios were 2.03 and 0.107, respectively, for PCT, and 1.72 and 0.067, respectively, for the combined studies. By multivariate analysis, high PCT values and abnormalities on US were independent predictors of dilating VUR. Conclusions: PCT is useful for diagnosing acute pyelonephritis and predicting dilating VUR in young children with a first febrile urinary tract infection. A voiding cystourethrography is indicated only in children with high PCT values (≥1.0 ng/mL) and/or abnormalities found on a US.
URI:	https://ir.csmu.edu.tw:8080/ir/handle/310902500/10460 http://dx.doi.org/10.1097/INF.0b013e3182905d83
Relation:	Pediatr Infect Dis J. 2013 Sep;32(9):e348-54.
Appears in Collections:	[醫學系] 期刊論文

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