Neutrophil Gelatinase-Associated Lipocalin as an Early Marker for the Diagnosis of Urinary Tract Infections in Saudi Children

Abstract

Background: Urinary tract infections (UTI) are widespread infections in the pediatric age group which presents non-specific symptoms. “Neutrophil gelatinase-associated lipocalin” (NGAL) is one of a biomarker in determining kidney injury. The early urinary tract infections diagnosis is essential for the purpose of preventing enduring consequences. Aim: To evaluate the use of NGAL as an early predictor of UTI in clinical practice. Patients and methods: A cross-sectional study examined specificity and sensitivity of urinary NGAL in the early UTI diagnosis. All febrile children admitted to KAAUH (age: 0-14 years) were included. Mann-Whitney U test, Shapiro- Wilk’s test, and Spearman correlation was used to analyze the data. Results: In terms of mean urinary NGAL, no significant difference was observed between urinary NGAL levels in patients with and without UTIs (P-value=0.17). The receiver operator characteristic (ROC) curve demonstrated 0.594 sensitivity, and 0.683 specificity. For serum CRP (ROC) curve demonstrated 0.53 sensitivity and 0.47 specificity. Spearman’s correlation was undertaken to examine an association between NGAL and CRP levels. There was a positive monotonic correlation between NGAL and CRP levels (rs= 0.503 n = 73, p < .001). Conclusion: Urinary NGAL is a poor biomarker for the diagnosis of febrile UTI. Further investigations are required with larger groups of patient to confirm the results of this study.