Procalcitonin is a predictor for high-grade vesicoureteral reflux in children: meta-analysis of individual patient data.
J Pediatr
; 159(4): 644-51.e4, 2011 Oct.
Article
en En
| MEDLINE
| ID: mdl-21511275
OBJECTIVE: To assess the predictive value of procalcitonin, a serum inflammatory marker, in the identification of children with first urinary tract infection (UTI) who might have high-grade (≥3) vesicoureteral reflux (VUR). STUDY DESIGN: We conducted a meta-analysis of individual data, including all series of children aged 1 month to 4 years with a first UTI, a procalcitonin (PCT) level measurement, cystograms, and an early dimercaptosuccinic acid scan. RESULTS: Of the 152 relevant identified articles, 12 studies representing 526 patients (10% with VUR ≥3) were included. PCT level was associated with VUR ≥3 as a continuous (P = .001), and as a binary variable, with a 0.5 ng/mL preferred threshold (adjusted OR, 2.5; 95% CI, 1.1 to 5.4). The sensitivity of PCT ≥0.5 ng/mL was 83% (95% CI, 71 to 91) with 43% specificity rate (95% CI, 38 to 47). In the subgroup of children with a positive results on dimercaptosuccinic acid scan, PCT ≥0.5 ng/mL was also associated with high-grade VUR (adjusted OR, 4.8; 95% CI, 1.3 to 17.6). CONCLUSIONS: We confirmed that PCT is a sensitive and validated predictor strongly associated with VUR ≥3, regardless of the presence of early renal parenchymal involvement in children with a first UTI.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Precursores de Proteínas
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Reflujo Vesicoureteral
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Calcitonina
Tipo de estudio:
Diagnostic_studies
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Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Límite:
Child, preschool
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Humans
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Infant
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Newborn
Idioma:
En
Revista:
J Pediatr
Año:
2011
Tipo del documento:
Article
Pais de publicación:
Estados Unidos