Journal of Comprehensive Pediatrics

Published by: Kowsar

Urinary Tract Infection in Children: Diagnostic and Prognostic Utility of Biomarkers

Samuel N. Uwaezuoke 1 , *
Author Information
1 MB, BS; FWACP, Honorary Consultant Pediatrician, Pediatric Nephrology Firm, Department of Pediatrics, University of Nigeria Teaching, Hospital (UNTH), Ituku-Ozalla, Enugu
Article information
  • Journal of Comprehensive Pediatrics: May 2017, 8 (2); e59248
  • Published Online: May 31, 2017
  • Article Type: Review Article
  • Received: November 13, 2016
  • Revised: March 31, 2017
  • Accepted: May 4, 2017
  • DOI: 10.5812/compreped.59248

To Cite: Uwaezuoke S N. Urinary Tract Infection in Children: Diagnostic and Prognostic Utility of Biomarkers, J Compr Ped. 2017 ; 8(2):e59248. doi: 10.5812/compreped.59248.

Copyright © 2017, Journal of Comprehensive Pediatrics. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Introduction
2. Literature Search Strategy
3. The Current Paradigm for Diagnostic Evaluation
4. Biomarkers as Diagnostic and Prognostic Tools in UTI
5. Interleukins (IL) and Acute Phase Reactants
6. Procalcitonin
7. Other Novel Biomarkers
8. Conclusions
  • 1. Srivastava RN, Bagga A. Pediatric Nephrology. 2005; : 235-64
  • 2. Rees L. Paediatric Nephrology-Oxford Specialist Handbooks in Paediatrics. 2012;
  • 3. Shaikh N, Morone NE, Bost JE, Farrell MH. Prevalence of urinary tract infection in childhood: a meta-analysis. Pediatr Infect Dis J. 2008; 27(4): 302-8[DOI][PubMed]
  • 4. Chang SL, Shortliffe LD. Pediatric urinary tract infections. Pediatr Clin North Am. 2006; 53(3): 379-400[DOI][PubMed]
  • 5. Larcombe J. Urinary tract infection in children. BMJ Clin Evid. 2010; 2010[PubMed]
  • 6. Leroy S, Gervaix A. [Procalcitonin, a useful biomarker in pediatric urinary tract infection]. Arch Pediatr. 2013; 20(1): 54-62[DOI][PubMed]
  • 7. Leroy S, Gervaix A. Procalcitonin: a key marker in children with urinary tract infection. Adv Urol. 2011; 2011: 397618[DOI][PubMed]
  • 8. Pecile P, Romanello C. Procalcitonin and pyelonephritis in children. Curr Opin Infect Dis. 2007; 20(1): 83-7[DOI][PubMed]
  • 9. Yilmaz A, Sevketoglu E, Gedikbasi A, Karyagar S, Kiyak A, Mulazimoglu M, et al. Early prediction of urinary tract infection with urinary neutrophil gelatinase associated lipocalin. Pediatr Nephrol. 2009; 24(12): 2387-92[DOI][PubMed]
  • 10. Benson M, Jodal U, Agace W, Hellstrom M, Marild S, Rosberg S, et al. Interleukin (IL)-6 and IL-8 in children with febrile urinary tract infection and asymptomatic bacteriuria. J Infect Dis. 1996; 174(5): 1080-4[PubMed]
  • 11. Kim BH, Yu N, Kim HR, Yun KW, Lim IS, Kim TH, et al. Evaluation of the optimal neutrophil gelatinase-associated lipocalin value as a screening biomarker for urinary tract infections in children. Ann Lab Med. 2014; 34(5): 354-9[DOI][PubMed]
  • 12. Daure E, Belanger MC, Beauchamp G, Lapointe C. Elevation of neutrophil gelatinase-associated lipocalin (NGAL) in non-azotemic dogs with urinary tract infection. Res Vet Sci. 2013; 95(3): 1181-5[DOI][PubMed]
  • 13. Yim HE, Yim H, Bae ES, Woo SU, Yoo KH. Predictive value of urinary and serum biomarkers in young children with febrile urinary tract infections. Pediatr Nephrol. 2014; 29(11): 2181-9[DOI][PubMed]
  • 14. Leroy S, Adamsbaum C, Marc E, Moulin F, Raymond J, Gendrel D, et al. Procalcitonin as a predictor of vesicoureteral reflux in children with a first febrile urinary tract infection. Pediatrics. 2005; 115(6)-9[DOI][PubMed]
  • 15. Leroy S, Romanello C, Galetto-Lacour A, Bouissou F, Fernandez-Lopez A, Smolkin V, et al. Procalcitonin is a predictor for high-grade vesicoureteral reflux in children: meta-analysis of individual patient data. J Pediatr. 2011; 159(4): 644-51 e4[DOI][PubMed]
  • 16. Sun HL, Wu KH, Chen SM, Chao YH, Ku MS, Hung TW, et al. Role of procalcitonin in predicting dilating vesicoureteral reflux in young children hospitalized with a first febrile urinary tract infection. Pediatr Infect Dis J. 2013; 32(9)-54[DOI][PubMed]
  • 17. Rahimzadeh N, Otukesh H, Hoseini R, Shadani S, Hooman N. Serum procalcitonin level for prediction of high-grade vesicoureteral reflux in urinary tract infection. Iran J Kidney Dis. 2014; 8(2): 105-8[PubMed]
  • 18. Mortazavi F, Ghojazadeh M. Usefulness of serum procalcitonin level for prediction of vesicoureteral reflux in pediatric urinary tract infection. Iran J Kidney Dis. 2014; 8(1): 37-41[PubMed]
  • 19. Sheu JN, Chen MC, Cheng SL, Lee IC, Chen SM, Tsay GJ. Urine interleukin-1beta in children with acute pyelonephritis and renal scarring. Nephrology (Carlton). 2007; 12(5): 487-93[DOI][PubMed]
  • 20. Leroy S, Fernandez-Lopez A, Nikfar R, Romanello C, Bouissou F, Gervaix A, et al. Association of procalcitonin with acute pyelonephritis and renal scars in pediatric UTI. Pediatrics. 2013; 131(5): 870-9[DOI][PubMed]
  • 21. Sheu JN, Chen MC, Chen SM, Chen SL, Chiou SY, Lue KH. Relationship between serum and urine interleukin-6 elevations and renal scarring in children with acute pyelonephritis. Scand J Urol Nephrol. 2009; 43(2): 133-7[DOI][PubMed]
  • 22. Chien JW, Wang LY, Cheng YS, Tsai YG, Liu CS. Urinary 8-hydroxy-2'-deoxyguanosine (8-oxodG) level can predict acute renal damage in young children with urinary tract infection. Biomarkers. 2014; 19(4): 326-31[DOI][PubMed]
  • 23. Benson M, Jodal U, Andreasson A, Karlsson A, Rydberg J, Svanborg C. Interleukin 6 response to urinary tract infection in childhood. Pediatr Infect Dis J. 1994; 13(7): 612-6[PubMed]
  • 24. Sheu JN, Chen MC, Lue KH, Cheng SL, Lee IC, Chen SM, et al. Serum and urine levels of interleukin-6 and interleukin-8 in children with acute pyelonephritis. Cytokine. 2006; 36(5-6): 276-82[DOI][PubMed]
  • 25. Nanda N, Juthani-Mehta M. Novel biomarkers for the diagnosis of urinary tract infection-a systematic review. Biomark Insights. 2009; 4: 111-21[PubMed]
  • 26. Urinary Tract Infection in Children. NICE Clinical Guideline 54. 2007;
  • 27. Robinson JL, Finlay JC, Lang ME, Bortolussi R. Urinary tract infections in infants and children: diagnosis and management. Paediatr Child Health. 2014; 19(6): 315-9
  • 28. Mischak H, Delles C, Vlahou A, Vanholder R. Proteomic biomarkers in kidney disease: issues in development and implementation. Nat Rev Nephrol. 2015; 11(4): 221-32[DOI][PubMed]
  • 29. Cruz DN, Goh CY, Haase-Fielitz A, Ronco C, Haase M. Early biomarkers of renal injury. Congest Heart Fail. 2010; 16 Suppl 1-31[DOI][PubMed]
  • 30. Agace W, Hedges S, Andersson U, Andersson J, Ceska M, Svanborg C. Selective cytokine production by epithelial cells following exposure to Escherichia coli. Infect Immun. 1993; 61(2): 602-9[PubMed]
  • 31. Hedges S, Agace W, Svensson M, Sjogren AC, Ceska M, Svanborg C. Uroepithelial cells are part of a mucosal cytokine network. Infect Immun. 1994; 62(6): 2315-21[PubMed]
  • 32. Wullt B, Bergsten G, Connell H, Rollano P, Gebratsedik N, Hang L, et al. P-fimbriae trigger mucosal responses to Escherichia coli in the human urinary tract. Cell Microbiol. 2001; 3(4): 255-64[PubMed]
  • 33. Svanborg C, Agace W, Hedges S, Lindstedt R, Svensson ML. Bacterial adherence and mucosal cytokine production. Ann N Y Acad Sci. 1994; 730: 162-81[PubMed]
  • 34. Agace WW, Hedges SR, Ceska M, Svanborg C. Interleukin-8 and the neutrophil response to mucosal gram-negative infection. J Clin Invest. 1993; 92(2): 780-5[DOI][PubMed]
  • 35. Jantausch BA, O'Donnell R, Wiedermann BL. Urinary interleukin-6 and interleukin-8 in children with urinary tract infection. Pediatr Nephrol. 2000; 15(3-4): 236-40[PubMed]
  • 36. Gurgoze MK, Akarsu S, Yilmaz E, Godekmerdan A, Akca Z, Ciftci I, et al. Proinflammatory cytokines and procalcitonin in children with acute pyelonephritis. Pediatr Nephrol. 2005; 20(10): 1445-8[DOI][PubMed]
  • 37. Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohuon C. High serum procalcitonin concentrations in patients with sepsis and infection. Lancet. 1993; 341(8844): 515-8[PubMed]
  • 38. Benador N, Siegrist CA, Gendrel D, Greder C, Benador D, Assicot M, et al. Procalcitonin is a marker of severity of renal lesions in pyelonephritis. Pediatrics. 1998; 102(6): 1422-5[PubMed]
  • 39. Smolkin V, Koren A, Raz R, Colodner R, Sakran W, Halevy R. Procalcitonin as a marker of acute pyelonephritis in infants and children. Pediatr Nephrol. 2002; 17(6): 409-12[DOI][PubMed]
  • 40. Pecile P, Miorin E, Romanello C, Falleti E, Valent F, Giacomuzzi F, et al. Procalcitonin: a marker of severity of acute pyelonephritis among children. Pediatrics. 2004; 114(2)-54[PubMed]
  • 41. Guven AG, Kazdal HZ, Koyun M, Aydn F, Gungor F, Akman S, et al. Accurate diagnosis of acute pyelonephritis: How helpful is procalcitonin? Nucl Med Commun. 2006; 27(9): 715-21[DOI][PubMed]
  • 42. Barati L, Safaeian B, Mehrjerdian M, Vakili MA. Early prediction of renal parenchymal injury with serum procalcitonin. J Renal Inj Prev. 2016; 5(3): 108-11[DOI][PubMed]
  • 43. Ghasemi K, Esteghamati M, Borzoo S, Parvaneh E, Borzoo S. Predictive Accuracy of Urinary neutrophil gelatinase associated lipocalin (NGAL) for renal parenchymal involvement in Children with Acute Pyelonephritis. Electron Physician. 2016; 8(2): 1911-7[DOI][PubMed]
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .
Readers' Comments