Usefulness of neutrophil-lymphocyte ratio in young children with febrile urinary tract infection.
10.3345/kjp.2016.59.3.139
- Author:
Song Yi HAN
1
;
I Re LEE
;
Se Jin PARK
;
Ji Hong KIM
;
Jae Il SHIN
Author Information
1. Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea. shinji@yuhs.ac
- Publication Type:Original Article
- Keywords:
Urinary tract infections;
Pyelonephritis;
Vesico-ureteral reflux;
Child;
Neutrophil-lymphocyte ratio
- MeSH:
Bacterial Infections;
Blood Cells;
C-Reactive Protein;
Child*;
Cicatrix;
Diagnosis;
Erythrocyte Count;
Humans;
Logistic Models;
Pyelonephritis;
Retrospective Studies;
ROC Curve;
Succimer;
Urinary Tract Infections*;
Urinary Tract*;
Vesico-Ureteral Reflux
- From:Korean Journal of Pediatrics
2016;59(3):139-144
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a useful marker to predict APN or vesicoureteral reflux (VUR). METHODS: We retrospectively evaluated 298 pediatric patients (age≤36 months) with febrile UTI from January 2010 to December 2014. Conventional infection markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and NLR were measured. RESULTS: WBC, CRP, ESR, and NLR were higher in APN than in lower UTI (P<0.001). Multiple logistic regression analyses showed that NLR was a predictive factor for positive dimercaptosuccinic acid (DMSA) defects (P<0.001). The area under the receiver operating characteristic (ROC) curve was high for NLR (P<0.001) as well as CRP (P<0.001) for prediction of DMSA defects. NLR showed the highest area under the ROC curve for diagnosis of VUR (P<0.001). CONCLUSION: NLR can be used as a diagnostic marker of APN with DMSA defect, showing better results than those of conventional markers for VUR prediction.
