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Abstract: FR-PO1085

Associations of Plasma Neutrophil Gelatinase-Associated Lipocalin, Anemia, and Renal Scarring in Children with Febrile Urinary Tract Infections

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Yim, Hyung Eun, Pediatrics, Korea University, Ansan-Si, Korea (the Republic of)
  • Yoo, Kee Hwan, Pediatrics, Korea University, Ansan-Si, Korea (the Republic of)
Background

Neutrophil gelatinase-associated lipocalin (NGAL), a bacteriostatic agent, is known to inhibit erythropoiesis leading to anemia. We aimed to investigate the relationships of NGAL, anemia, and renal scarring in children with febrile urinary tract infections (UTIs).

Methods

We retrospectively reviewed the medical records of 261 children with first febrile UTIs. The associations between plasma NGAL levels and indices of anemia were studied. NGAL performance in comparison with serum C-reactive protein (CRP) at admission and after 72 hours of antibiotic treatment was also evaluated for the prediction of renal scarring.

Results

Plasma NGAL levels were considerably elevated in patients with anemia compared with those without anemia (P < 0.001). NGAL concentrations were inversely correlated with levels of hemoglobin and hematocrit and red blood cell count (all P < 0.001). Increased NGAL, but not CRP, was independently associated with the presence of anemia in a multivariable logistic analysis [OR 2.37 (95% CI 1.07-5.27), P < 0.05]. Receiver operating curve analyses showed good diagnostic profiles of NGAL at admission and after treatment for identifying renal scarring (all P < 0.05). Plasma NGAL after treatment showed a higher area under the curve (AUC) (0.730; 95% CI 0.591–0.843) than that of CRP after treatment (AUC 0.520; 95% CI 0.395–0.643) (P < 0.05). In a multivariable analysis, elevated plasma NGAL level at admission and the presence of anemia were independently associated with the presence of renal scarring in children with febrile UTIs (all P < 0.05). In the presence of anemia, NGAL concentration increased consecutively in febrile UTI, APN, and renal scar (P < 0.05).

Conclusion

Increased plasma NGAL levels may be associated with the presence of anemia and renal scarring in children with febrile UTIs.

Plasma NGAL levels at admission in febrile UTI, APN, and renal scar (*P < 0.05, febrile UTI vs. APN & scar, **P < 0.05, APN vs. renal scar)