Leroy, Sandrine
Romanello, Carla
Galetto-Lacour, Annick
Bouissou, François
Fernandez-Lopez, Anna
Smolkin, Vladislav
Gurgoz, Metin K.
Bressan, Silvia
Karavanaki, Kyriaki
Tuerlinckx, David
[UCL]
Leblond, P.
Pecile, Pierre
Coulais, Yvon
Cubells, Carlos
Halevy, Raphael
Aygun, A. Denizmen
Da Dalt, Liliana
Stefanidis, Constantinos J.
Vander Borght, Thierry
[UCL]
Bigot, Sandra
Dubos, François
Gervaix, Alain
Chalumeau, Martin
et al. [show all ]
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.
Bibliographic reference
Leroy, Sandrine ; Romanello, Carla ; Galetto-Lacour, Annick ; Bouissou, François ; Fernandez-Lopez, Anna ; et. al. Procalcitonin is a predictor for high-grade vesicoureteral reflux in children: Meta-analysis of individual patient data. In: Journal of Pediatrics , Vol. 159, no.4, p. 644-651.e4 (2011)
Permanent URL
http://hdl.handle.net/2078.1/123243