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Evaluation of the optimal neutrophil gelatinase-associated lipocalin value as a screening biomarker for urinary tract infections in children.

Kim BH, Yu N, Kim HR, Yun KW, Lim IS, Kim TH, Lee MK - Ann Lab Med (2014)

Bottom Line: UTI was diagnosed on the basis of culture results and symptoms reported by the patients.NGAL values were measured by using ELISA.NGAL values were more elevated in the UTI cases than in the non-UTI cases, but the difference between the values were not statistically significant (P=0.190 for sNGAL and P=0.064 for uNGAL).

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker in the detection of kidney injury. Early diagnosis of urinary tract infection (UTI), one of the most common infections in children, is important in order to avert long-term consequences. We assessed whether serum NGAL (sNGAL) or urine NGAL (uNGAL) would be reliable markers of UTI and evaluated the appropriate diagnostic cutoff value for the screening of UTI in children.

Methods: A total of 812 urine specimens and 323 serum samples, collected from pediatric patients, were analyzed. UTI was diagnosed on the basis of culture results and symptoms reported by the patients. NGAL values were measured by using ELISA.

Results: NGAL values were more elevated in the UTI cases than in the non-UTI cases, but the difference between the values were not statistically significant (P=0.190 for sNGAL and P=0.064 for uNGAL). The optimal diagnostic cutoff values of sNGAL and uNGAL for UTI screening were 65.25 ng/mL and 5.75 ng/mL, respectively.

Conclusions: We suggest that it is not appropriate to use NGAL as a marker for early diagnosis of UTI in children.

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Related in: MedlinePlus

ROC curves to detect urinary tract infection (UTI). The blue line is ROC curve for serum neutrophil gelatinase-associated lipocalin (sNGAL) (area under the curve [AUC]=0.534; 95% CI, 0.308-0.812). By using a cutoff value of 65.25 ng/mL for the diagnosis of UTI, sensitivity and specificity were 70% and 35%, respectively (blue dot). The red line is ROC curve for urine neutrophil gelatinase-associated lipocalin (uNGAL) (AUC=0.576; 95% CI, 0.347-0.799). By using a cutoff value of 5.75 ng/mL for the diagnosis of UTI, sensitivity and specificity were 70% and 42%, respectively (red dot).
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Figure 1: ROC curves to detect urinary tract infection (UTI). The blue line is ROC curve for serum neutrophil gelatinase-associated lipocalin (sNGAL) (area under the curve [AUC]=0.534; 95% CI, 0.308-0.812). By using a cutoff value of 65.25 ng/mL for the diagnosis of UTI, sensitivity and specificity were 70% and 35%, respectively (blue dot). The red line is ROC curve for urine neutrophil gelatinase-associated lipocalin (uNGAL) (AUC=0.576; 95% CI, 0.347-0.799). By using a cutoff value of 5.75 ng/mL for the diagnosis of UTI, sensitivity and specificity were 70% and 42%, respectively (red dot).

Mentions: The values of sNGAL and uNGAL were elevated in the UTI group compared to the non-UTI group; however, there was no significant difference in the mean values between the groups (Table 1). According to ROC analysis, the optimal diagnostic cutoff values to predict UTI were 65.25 ng/mL for sNGAL and 5.75 ng/mL for uNGAL. If a cutoff of 65.25 ng/mL for sNGAL for diagnosing UTI was used, the sensitivity and specificity of the diagnosis were 70% (95% confidence interval [CI], 18%-79%) and 35% (95% CI, 20%-74%), respectively (Fig. 1). For uNGAL, using a cutoff value of 5.75 ng/mL for diagnosing UTI, the sensitivity and specificity of diagnosis were 70% (95% CI, 21%-83%) and 42% (95% CI, 36%-89%), respectively (Fig. 1).


Evaluation of the optimal neutrophil gelatinase-associated lipocalin value as a screening biomarker for urinary tract infections in children.

Kim BH, Yu N, Kim HR, Yun KW, Lim IS, Kim TH, Lee MK - Ann Lab Med (2014)

ROC curves to detect urinary tract infection (UTI). The blue line is ROC curve for serum neutrophil gelatinase-associated lipocalin (sNGAL) (area under the curve [AUC]=0.534; 95% CI, 0.308-0.812). By using a cutoff value of 65.25 ng/mL for the diagnosis of UTI, sensitivity and specificity were 70% and 35%, respectively (blue dot). The red line is ROC curve for urine neutrophil gelatinase-associated lipocalin (uNGAL) (AUC=0.576; 95% CI, 0.347-0.799). By using a cutoff value of 5.75 ng/mL for the diagnosis of UTI, sensitivity and specificity were 70% and 42%, respectively (red dot).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4151003&req=5

Figure 1: ROC curves to detect urinary tract infection (UTI). The blue line is ROC curve for serum neutrophil gelatinase-associated lipocalin (sNGAL) (area under the curve [AUC]=0.534; 95% CI, 0.308-0.812). By using a cutoff value of 65.25 ng/mL for the diagnosis of UTI, sensitivity and specificity were 70% and 35%, respectively (blue dot). The red line is ROC curve for urine neutrophil gelatinase-associated lipocalin (uNGAL) (AUC=0.576; 95% CI, 0.347-0.799). By using a cutoff value of 5.75 ng/mL for the diagnosis of UTI, sensitivity and specificity were 70% and 42%, respectively (red dot).
Mentions: The values of sNGAL and uNGAL were elevated in the UTI group compared to the non-UTI group; however, there was no significant difference in the mean values between the groups (Table 1). According to ROC analysis, the optimal diagnostic cutoff values to predict UTI were 65.25 ng/mL for sNGAL and 5.75 ng/mL for uNGAL. If a cutoff of 65.25 ng/mL for sNGAL for diagnosing UTI was used, the sensitivity and specificity of the diagnosis were 70% (95% confidence interval [CI], 18%-79%) and 35% (95% CI, 20%-74%), respectively (Fig. 1). For uNGAL, using a cutoff value of 5.75 ng/mL for diagnosing UTI, the sensitivity and specificity of diagnosis were 70% (95% CI, 21%-83%) and 42% (95% CI, 36%-89%), respectively (Fig. 1).

Bottom Line: UTI was diagnosed on the basis of culture results and symptoms reported by the patients.NGAL values were measured by using ELISA.NGAL values were more elevated in the UTI cases than in the non-UTI cases, but the difference between the values were not statistically significant (P=0.190 for sNGAL and P=0.064 for uNGAL).

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea.

ABSTRACT

Background: Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker in the detection of kidney injury. Early diagnosis of urinary tract infection (UTI), one of the most common infections in children, is important in order to avert long-term consequences. We assessed whether serum NGAL (sNGAL) or urine NGAL (uNGAL) would be reliable markers of UTI and evaluated the appropriate diagnostic cutoff value for the screening of UTI in children.

Methods: A total of 812 urine specimens and 323 serum samples, collected from pediatric patients, were analyzed. UTI was diagnosed on the basis of culture results and symptoms reported by the patients. NGAL values were measured by using ELISA.

Results: NGAL values were more elevated in the UTI cases than in the non-UTI cases, but the difference between the values were not statistically significant (P=0.190 for sNGAL and P=0.064 for uNGAL). The optimal diagnostic cutoff values of sNGAL and uNGAL for UTI screening were 65.25 ng/mL and 5.75 ng/mL, respectively.

Conclusions: We suggest that it is not appropriate to use NGAL as a marker for early diagnosis of UTI in children.

Show MeSH
Related in: MedlinePlus