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KMID : 1130320160590030139
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Korean Journal of Pediatrics
2016 Volume.59 No. 3 p.139 ~ p.144
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Usefulness of neutrophil-lymphocyte ratio in young children with febrile urinary tract infection
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:Han Song-Yi
:Lee I-Re/:Park Se-Jin/:Kim Ji-Hong/:Shin Jae-Il
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Abstract
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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.
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KEYWORD
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Urinary tract infections, Pyelonephritis, Vesico-ureteral reflux, Child, Neutrophil-lymphocyte ratio
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