Procalcitonin is a predictor for high-grade vesicoureteral reflux in children: Meta-analysis of individual patient data
(2011) The Journal of Pediatrics — Vol. 159, n° 4, p. 644-651 (2011)
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- 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. © 2011 Mosby Inc. All rights reserved.
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Leroy, S., Romanello, C., Galetto-Lacour, A., Bouissou, F., Fernandez-Lopez, A., Smolkin, V., Gurgoz, M. K., Bressan, S., Karavanaki, K., Tuerlinckx, D., Leblond, P., Pecile, P., Coulais, Y., Cubells, C., Halevy, R., Aygun, A. D., Da Dalt, L., Stefanidis, C. J., Vander Borght, T., et al. (2011). Procalcitonin is a predictor for high-grade vesicoureteral reflux in children: Meta-analysis of individual patient data. The Journal of Pediatrics, 159(4), 644-651. https://doi.org/10.1016/j.jpeds.2011.03.008 (Original work published 2011)