Can Procalcitonin Reduce Unnecessary Voiding Cystoureterography in Children with First Febrile Urinary Tract Infection?

Aliasghar  Halimi-asl; Amir Hossein  Hosseini; Pooneh  Nabavizadeh

IJ Pediatrics

The Scientific Journal of Growth & Development Research Center

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Can Procalcitonin Reduce Unnecessary Voiding Cystoureterography in Children with First Febrile Urinary Tract Infection?

Author(s):

Aliasghar Halimi-asl¹,

Amir Hossein Hosseini^2,*,

Pooneh Nabavizadeh³

IJ Pediatrics:Vol. 24, issue 4; 418-422

Published online:Jul 19, 2014

Article type:Research Article

Received:Nov 05, 2013

Accepted:May 02, 2014

How to Cite:Aliasghar Halimi-aslAmir Hossein HosseiniPooneh NabavizadehCan Procalcitonin Reduce Unnecessary Voiding Cystoureterography in Children with First Febrile Urinary Tract Infection?.Iran J Pediatr.24(4):418-422.

Abstract

Objective: Recently, new predictors of vesicoureteral reflux (VUR) in children with a first febrile UTI such as Procalcitonin (PCT) were introduced as selective approaches for cystography. This study wants to show the capability of PCT in predicting presence of VUR at the first febrile UTI in children.Methods: Patients between 1 month and 15 years of age with febrile UTI were included in this prospective study. PCT values were measured through a semi-quantitative method in four grades comprising values less than 0.5, 0.5-2.0, 2.0-10.0 and above 10.0 ng/ml. The independence of PCT levels in predicting VUR were assessed after adjustment for all potential confounders using a logistic-regression model.Findings: A total of 68 patients, 54 (79.4%) girls and 14 (20.6%) boys were evaluated. PCT level demonstrated a significant difference between patients with positive VUR and those with negative VUR (P=0.012). To calculate the independent factors that may predict the presence of VUR, all included variables were adjusted for age and sex. Results of logistic regression showed that a PCT level between 2.0 and 10.0 ng/mL could independently predict presence of VUR (Odds ratio=6.11, CI 95%= 1.22-30.77, P=0.03).Conclusion: Our finding in this study showed that readily available semi-quantitative measures for PCT are feasible for detecting patients with VUR. We suggest that in semi-quantitative measurements of PCT, levels between 2.0 and 10.0 ng/ml could be an independent predictor of positive VUR.

Keywords

Urinary Tract Infection

Procalcitonin Levels

Vesicoureteral Reflux

Voiding Cystourethrogram

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