Korean J Pediatr.  2016 Mar;59(3):139-144. 10.3345/kjp.2016.59.3.139.

Usefulness of neutrophil-lymphocyte ratio in young children with febrile urinary tract infection

• Han SY
• Lee IR
• Park SJ
• Kim JH
• Shin JI

• KMID: 2163058
• DOI: http://doi.org/10.3345/kjp.2016.59.3.139

Abstract

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≤36 months) 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.

Keyword

Urinary tract infections; Pyelonephritis; Vesico-ureteral reflux; Child; Neutrophil-lymphocyte ratio

MeSH Terms

Bacterial Infections
Blood Cells
C-Reactive Protein
Child*
Cicatrix
Diagnosis
Erythrocyte Count
Humans
Logistic Models
Pyelonephritis
Retrospective Studies
ROC Curve
Succimer
Urinary Tract Infections*
Urinary Tract*
Vesico-Ureteral Reflux
C-Reactive Protein
Succimer