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

Authors
 Jung Won Lee  ;  Sun Mi Her  ;  Ji Hong Kim  ;  Keum Hwa Lee  ;  Michael Eisenhut  ;  Se Jin Park  ;  Jae Il Shin 
Citation
 Pediatric Nephrology, Vol.33(4) : 631-637, 2018 
Journal Title
 Pediatric Nephrology 
ISSN
 0931-041X 
Issue Date
2018
Keywords
Children ; D-dimer ; Infants ; Inflammatory marker ; Urinary tract infection
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 D-dimer (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.
Full Text
https://link.springer.com/article/10.1007%2Fs00467-017-3843-9
DOI
10.1007/s00467-017-3843-9
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실)
Yonsei Authors
김지홍(Kim, Ji Hong) ORCID logo https://orcid.org/0000-0001-5352-5423
신재일(Shin, Jae Il) ORCID logo https://orcid.org/0000-0003-2326-1820
이금화(Lee, Keum Hwa) ORCID logo https://orcid.org/0000-0002-1511-9587
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162446
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