Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Usefulness of neutrophil-lymphocyte ratio in young children with febrile urinary tract infection

  • Han, Song Yi (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Lee, I Re (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Park, Se Jin (Department of Pediatrics, Daewoo General Hospital, Ajou University School of Medicine) ;
  • Kim, Ji Hong (Department of Pediatrics, Yonsei University College of Medicine) ;
  • Shin, Jae Il (Department of Pediatrics, Yonsei University College of Medicine)
  • 투고 : 2015.08.06
  • 심사 : 2015.10.28
  • 발행 : 2016.03.15
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초록

Purpose: Acute pyelonephritis (APN) is a serious bacterial infection that can cause renal scarring in children. Early identification of APN is critical to improve treatment outcomes. The neutrophil-lymphocyte ratio (NLR) is a prognostic marker of many diseases, but it has not yet been established in urinary tract infection (UTI). The aim of this study was to determine whether NLR is a useful marker to predict APN or vesicoureteral reflux (VUR). Methods: We retrospectively evaluated 298 pediatric patients ($age{\leq}36months$) with febrile UTI from January 2010 to December 2014. Conventional infection markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP]), and NLR were measured. Results: WBC, CRP, ESR, and NLR were higher in APN than in lower UTI (P<0.001). Multiple logistic regression analyses showed that NLR was a predictive factor for positive dimercaptosuccinic acid (DMSA) defects (P<0.001). The area under the receiver operating characteristic (ROC) curve was high for NLR (P<0.001) as well as CRP (P<0.001) for prediction of DMSA defects. NLR showed the highest area under the ROC curve for diagnosis of VUR (P<0.001). Conclusion: NLR can be used as a diagnostic marker of APN with DMSA defect, showing better results than those of conventional markers for VUR prediction.

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참고문헌

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