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- Title
D-dimer as a marker of acute pyelonephritis in infants younger than 24 months with urinary tract infection.
- Authors
Lee, Jung Won; Her, Sun Mi; Kim, Ji Hong; Lee, Keum Hwa; Eisenhut, Michael; Park, Se Jin; Shin, Jae Il
- Abstract
Background: D-dimer, as well as other biomarkers related to coagulation, is significantly increased during severe bacterial infection and sepsis. The aim of this study was to evaluate the usefulness of serum D-dimer as a biological marker in diagnosing acute pyelonephritis (APN) and in predicting vesicoureteric reflux (VUR) in infants with urinary tract infection (UTI).Methods: We retrospectively analyzed the data of 177 young infants (<2 years) with febrile UTI between 2005 and 2014, grouped as APN and lower UTI groups. Conventional inflammatory markers (white blood cell count (WBC), erythrocyte sedimentation rates (ESR), C-reactive protein (CRP)), and D-dimer were measured.Results: The WBC counts (<italic>P</italic> = 0.002), ESR (<italic>P <</italic> 0.0001), CRP (<italic>P</italic> < 0.0001), D-dimer levels (<italic>P</italic> = 0.006) and the presence of VUR (<italic>P <</italic> 0.0001) were significantly higher in the APN group than in the lower UTI group. Multiple logistic regression analyses showed that D-dimer (odds ratio [OR]:1.003, 95% CI: 1.001-1.006, <italic>P</italic> = 0.002) was an independent predictive factor for VUR in young children with UTI. The area under the curve (AUC) value from the receiver operating characteristic (ROC) curve of D-dimer (0.621, <italic>P</italic> = 0.046, 95% CI: 0.499-0.743) for prediction of VUR was higher than other inflammatory markers, but was inferior to CRP in predicting APN.Conclusions: Our results demonstrate that D-dimer can be used as an inflammatory marker in infants with febrile UTI in addition to other inflammatory markers.
- Subjects
INFLAMMATION; PYELONEPHRITIS; URINARY tract infections; RETROSPECTIVE studies; FIBRIN fibrinogen degradation products
- Publication
Pediatric Nephrology, 2018, Vol 33, Issue 4, p631
- ISSN
0931-041X
- Publication type
Article
- DOI
10.1007/s00467-017-3843-9