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. 2024 Sep 3;11(9):1081.
doi: 10.3390/children11091081.

Plasma and Urinary Neutrophil Gelatinase-Associated Lipocalin as Predictors of Renal Parenchymal Involvement in Children with Febrile Urinary Tract Infection: A Pilot Study

Emma Baranton  1 , Chloé Ribet  1 , Emma Freyssinet  1 , Julie Bernardor  2   3 , Corinne Boyer  4 , Florence Lavrut-Hollecker  5 , Diane Demonchy  1 , Emma Schuler  3 , Eric Fontas  6 , Antoine Tran  1   3
Affiliations

Plasma and Urinary Neutrophil Gelatinase-Associated Lipocalin as Predictors of Renal Parenchymal Involvement in Children with Febrile Urinary Tract Infection: A Pilot Study

Emma Baranton et al. Children (Basel). .

Abstract

Background: Urinary tract infections (UTIs) are very common bacterial infections in children. Early detection of renal parenchymal involvement in this setting can help clinicians make more effective treatment choices. The aim of this pilot study was to assess the ability of plasma and urinary neutrophil gelatinase-associated lipocalin (pNGAL and uNGAL) levels, measured using an automated system, to accurately predict renal parenchymal involvement in children with febrile UTIs.

Methods: This prospective single-center study included 28 children aged ≥ 4 years with a first episode of febrile UTIs. All patients underwent magnetic resonance imaging. pNGAL, uNGAL, procalcitonin, C-reactive protein (CRP), and white blood cells were measured before antibiotic therapy.

Results: The receiver operating characteristic (ROC) area under the curve for predicting acute pyelonephritis was 0.6 for pNGAL, 0.8 for CRP, 0.4 for PCT, and 0.4 for uNGAL. The ROC analyses showed an optimal cutoff of 141.0 ng/mL for pNGAL (sensitivity, 54.2%; specificity, 75.0%; positive predictive value, 92.9%; and negative predictive value, 21.4%).

Conclusion: pNGAL and uNGAL did not effectively aid the early prediction of renal parenchymal involvement in children ≥ 4 years with febrile UTIs. The novelties of this study were the use of MRI as the gold standard and an automated biochemical method to measure NGAL.

Keywords: MRI; NGAL; acute pyelonephritis; children; neutrophil gelatinase-associated lipocalin; urinary tract infection.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study flow diagram. Abbreviations: MRI, magnetic resonance imaging; NGAL, neutrophil gelatinase-associated lipocalin.
Figure 2
Figure 2
ROC analysis of pNGAL (a), uNGAL (b), CRP (c), PCT (d) levels, WBCs (e), and neutrophils (f) for predicting renal parenchymal involvement. Abbreviations: CRP, C-reactive protein; PCT, procalcitonin; pNGAL, plasma neutrophil gelatinase-associated lipocalin; uNGAL, urinary neutrophil gelatinase-associated lipocalin; WBCs, white blood cells.
Figure 3
Figure 3
Correlation analysis between pNGAL and CRP (a), PCT (b), WBC (c), and neutrophils (d). Abbreviations: CRP, C-reactive protein; PCT, procalcitonin; pNGAL, plasma neutrophil gelatinase-associated lipocalin; WBCs, white blood cells.
See this image and copyright information in PMC

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Grants and funding

This research was funded by the annual institutional, grant number N° 18-HPNCL-08. This grant was used to measure NGAL and to perform statistical analysis carried out by the department of clinical research.

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