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MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children
BACKGROUND: Midregional-proadrenomedullin (MR-proADM) is a useful prognostic peptide in severe infectious pathologies in the adult population. However, there are no studies that analyze its utility in febrile urinary tract infection (fUTI) in children. An accurate biomarker would provide an early de...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240321/ https://www.ncbi.nlm.nih.gov/pubmed/34187408 http://dx.doi.org/10.1186/s12887-021-02765-2 |
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author | Peñalver Penedo, Rafael Rupérez Lucas, Marta Álvarez-Sala Walther, Luis Antonio Torregrosa Benavent, Alicia Casas Losada, María Luisa Bañuelos Andrio, Luis Rebolledo Poves, Ana Belén Bueno Campaña, Mercedes |
author_facet | Peñalver Penedo, Rafael Rupérez Lucas, Marta Álvarez-Sala Walther, Luis Antonio Torregrosa Benavent, Alicia Casas Losada, María Luisa Bañuelos Andrio, Luis Rebolledo Poves, Ana Belén Bueno Campaña, Mercedes |
author_sort | Peñalver Penedo, Rafael |
collection | PubMed |
description | BACKGROUND: Midregional-proadrenomedullin (MR-proADM) is a useful prognostic peptide in severe infectious pathologies in the adult population. However, there are no studies that analyze its utility in febrile urinary tract infection (fUTI) in children. An accurate biomarker would provide an early detection of patients with kidney damage, avoiding other invasive tests like renal scintigraphy scans. Our objective is to study the usefulness of MR-proADM as a biomarker of acute and chronic renal parenchymal damage in fUTI within the pediatric population. METHODS: A prospective cohort study was conducted in pediatric patients with fUTI between January 2015 and December 2018. Plasma and urine MR-proADM levels were measured at admission in addition to other laboratory parameters. After confirmation of fUTI, renal scintigraphy scans were performed during the acute and follow-up stages. A descriptive study has been carried out and sensitivity, specificity and ROC curves for MR-proADM, C-reactive protein, and procalcitonin were calculated. RESULTS: 62 pediatric patients (34 female) were enrolled. Scintigraphy showed acute pyelonephritis in 35 patients (56.5%). Of those patients, the median of plasmatic MR-proADM (P-MR-proADM) showed no differences compared to patients without pyelonephritis. 7 patients (11.3%) developed renal scars (RS). Their median P-MR-proADM levels were 1.07 nmol/L (IQR 0.66–1.59), while in patients without RS were 0.48 nmol/L (0.43–0.63) (p < 0.01). The AUC in this case was 0.92 (95% CI 0.77–0.99). We established an optimal cut-off point at 0.66 nmol/L with sensitivity 83.3% and specificity 81.8%. CONCLUSION: MR-ProADM has demonstrated a poor ability to diagnose pyelonephritis in pediatric patients with fUTI. However, P-MR-proADM proved to be a very reliable biomarker for RS prediction. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-021-02765-2. |
format | Online Article Text |
id | pubmed-8240321 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-82403212021-06-30 MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children Peñalver Penedo, Rafael Rupérez Lucas, Marta Álvarez-Sala Walther, Luis Antonio Torregrosa Benavent, Alicia Casas Losada, María Luisa Bañuelos Andrio, Luis Rebolledo Poves, Ana Belén Bueno Campaña, Mercedes BMC Pediatr Research Article BACKGROUND: Midregional-proadrenomedullin (MR-proADM) is a useful prognostic peptide in severe infectious pathologies in the adult population. However, there are no studies that analyze its utility in febrile urinary tract infection (fUTI) in children. An accurate biomarker would provide an early detection of patients with kidney damage, avoiding other invasive tests like renal scintigraphy scans. Our objective is to study the usefulness of MR-proADM as a biomarker of acute and chronic renal parenchymal damage in fUTI within the pediatric population. METHODS: A prospective cohort study was conducted in pediatric patients with fUTI between January 2015 and December 2018. Plasma and urine MR-proADM levels were measured at admission in addition to other laboratory parameters. After confirmation of fUTI, renal scintigraphy scans were performed during the acute and follow-up stages. A descriptive study has been carried out and sensitivity, specificity and ROC curves for MR-proADM, C-reactive protein, and procalcitonin were calculated. RESULTS: 62 pediatric patients (34 female) were enrolled. Scintigraphy showed acute pyelonephritis in 35 patients (56.5%). Of those patients, the median of plasmatic MR-proADM (P-MR-proADM) showed no differences compared to patients without pyelonephritis. 7 patients (11.3%) developed renal scars (RS). Their median P-MR-proADM levels were 1.07 nmol/L (IQR 0.66–1.59), while in patients without RS were 0.48 nmol/L (0.43–0.63) (p < 0.01). The AUC in this case was 0.92 (95% CI 0.77–0.99). We established an optimal cut-off point at 0.66 nmol/L with sensitivity 83.3% and specificity 81.8%. CONCLUSION: MR-ProADM has demonstrated a poor ability to diagnose pyelonephritis in pediatric patients with fUTI. However, P-MR-proADM proved to be a very reliable biomarker for RS prediction. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12887-021-02765-2. BioMed Central 2021-06-29 /pmc/articles/PMC8240321/ /pubmed/34187408 http://dx.doi.org/10.1186/s12887-021-02765-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Peñalver Penedo, Rafael Rupérez Lucas, Marta Álvarez-Sala Walther, Luis Antonio Torregrosa Benavent, Alicia Casas Losada, María Luisa Bañuelos Andrio, Luis Rebolledo Poves, Ana Belén Bueno Campaña, Mercedes MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children |
title | MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children |
title_full | MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children |
title_fullStr | MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children |
title_full_unstemmed | MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children |
title_short | MR-Proadrenomedullin as biomarker of renal damage in urinary tract infection in children |
title_sort | mr-proadrenomedullin as biomarker of renal damage in urinary tract infection in children |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240321/ https://www.ncbi.nlm.nih.gov/pubmed/34187408 http://dx.doi.org/10.1186/s12887-021-02765-2 |
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