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D-dimer as a marker of acute pyelonephritis in infants younger than 24 months with urinary tract infection

Title
D-dimer as a marker of acute pyelonephritis in infants younger than 24 months with urinary tract infection
Authors
Lee, Jung WonHer, Sun MiKim, Ji HongLee, Keum HwaEisenhut, MichaelPark, Se JinShin, Jae Il
Ewha Authors
이정원
SCOPUS Author ID
이정원scopus
Issue Date
2018
Journal Title
PEDIATRIC NEPHROLOGY
ISSN
0931-041XJCR Link1432-198XJCR Link
Citation
vol. 33, no. 4, pp. 631 - 637
Keywords
Urinary tract infectionInfantsD-dimerInflammatory markerChildren
Publisher
SPRINGER
Indexed
SCI; SCIE; SCOPUS WOS scopus
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 (P = 0.002), ESR (P < 0.0001), CRP (P < 0.0001), D-dimer levels (P = 0.006) and the presence of VUR (P< 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, P = 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 Ddimer (0.621, P = 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.
DOI
10.1007/s00467-017-3843-9
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의료원 > 의료원 > Journal papers
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