Neutrophil gelatinase-associated lipocalin as a biomarker for the diagnosis of urinary tract infection in children

Urinary tract infection (UTI) is common in childhood and may have important consequences. The reference standard for the diagnosis is urine culture, but it requires time for bacterial growth. Neutrophil gelatinase-associated lipocalin (NGAL) has been shown to be elevated after kidney injury. This study aims to investigate the usefullness of blood and urine NGAL levels in children with UTI. Fifty-nine patients with UTI (29 with pyelonephritis, 30 with lower UTI) and 28 healthy controls were enrolled in the study. NGAL values were determined by using ELISA. Urine NGAL and urine NGAL/creatinine levels were significantly higher in patients with UTI than healthy controls (p<0.001) as well as in patients with pyelonephritis than in patients with lower UTI (p=0.016 for urine NGAL, p=0.001 for urine NGAL/creatinine). Besides, plasma NGAL levels were found to be higher in patients with pyelonephritis than patients with lower UTI (p=0.015) and healthy controls (p=0.016). In conclusion, urine NGAL and urine NGAL/creatinine can be used for the detection of UTI and the differential diagnosis of pyelonephritis and lower UTI. Plasma NGAL can also be useful for determining pyelonephritis in children.

Key words: VNGAL, children, Neutrophil gelatinase associated lipocalin, Lipocalin, urinary tract infection