Procalcitonin may be a better predictor of acute pyelonephritis than C-reactive protein or white blood cell counts during the early stages of urinary tract infections in children, according to study findings published online.
Sandrine Leroy, MD, PhD, of the Centre for Statistics in Medicine, University of Oxford, Wolfson College Annexe in the United Kingdom, and colleagues published data from a literature search of studies reporting individual patient results who had undergone early or late dimercaptosuccinic acid and measurements of C-reactive protein (CRP), white blood count and procalcitonin.
The 18 studies that met the inclusion criteria included 1,011 patients; most of whom had been diagnosed with acute pyelonephritis (APN).
Results of the study revealed that “procalcitonin ≥0.5 ng/mL yielded an adjusted OR of 7.9 (95% CI, 5.8-10.9) with 71% sensitivity (95% CI, 67-74) and 72% specificity (95% CI, 67-76) for APN. Procalcitonin ≥0.5 ng/mL was significantly associated with late scarring (adjusted OR=3.4; 95% CI, 2.1-5.7) with 79% sensitivity (95% CI, 71-85) and 50% specificity (95% CI, 45-54).”
Procalcitonin was associated with APN and scarring and demonstrated a significantly higher area under the receiver operating characteristic curve than either CRP or white blood cell count, the researchers concluded. They also noted that procalcitonin was a predictor of late renal scarring.
Leroy reports no relevant financial disclosures.