Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Association between Elevated Alanine Aminotransferase and Urosepsis in Children with Acute Pyelonephritis

  • Kim, Dongwan (Department of Pediatrics, Gachon University Gil Medical Center) ;
  • Lee, Sung Hyun (Department of Pediatrics, Gachon University Gil Medical Center) ;
  • Tchah, Hann (Department of Pediatrics, Gachon University Gil Medical Center) ;
  • Ryoo, Eell (Department of Pediatrics, Gachon University Gil Medical Center) ;
  • Cho, Hye Kyung (Department of Pediatrics, Gachon University Gil Medical Center) ;
  • Kim, Yun Mi (Department of Nursing, Gachon University)
  • Received : 2015.07.03
  • Accepted : 2015.10.19
  • Published : 2016.03.30
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Abstract

Purpose: The aim of this study is to investigate the association between elevated alanine aminotransferase (ALT) and urosepsis in children with acute pyelonephritis (APN). Methods: We retrospectively identified all children who were managed in our hospital with APN during a decade period. In our study a diagnosis of APN was defined as having a positive urine culture and a positive (99m)Tc-dimercaptosuccinic acid scintigraphy. We compared those with elevated ALT and those with normal ALT according to the following variables: age, gender, duration of fever prior to admission, presence of hypotension, C-reactive protein (CRP), creatinine, presence of anemia, white blood cells count, platelet count, blood culture result, and grades of vesicoureteral reflux. In addition, the correlation between elevated ALT and positive blood culture was analyzed in detail. Results: A total of 996 children were diagnosed with APN, of which 883 were included in the study. ALT was elevated in 81 children (9.2%). In the analysis of demographic characteristics, the number of children with elevated ALT was higher in children between 0 to 3 months, boys, and in those with positive blood culture (p=0.002, 0.036, and 0.010, respectively). In multivariate analysis of variables associated with positive blood culture, age younger than 3 months, elevated ALT, elevated CRP, and elevated creatinine showed statistical significance (p=0.004, 0.030, 0.043, and 0.044, respectively). Conclusion: Our study demonstrates the association between elevated ALT and increased prevalence of urosepsis in addition to elevated CRP, elevated creatinine, and age younger than 3 months in children with APN.

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