Are Plasma Neutrophil Gelatinase Associated Lipocalin Levels Diagnostic in Uncomplicated Urinary Tract Infections?
Abstract
Objectives: Acute uncomplicated lower urinary tract infections are among the most common causes for emergency department visits and empirical antibiotic prescriptions. The purpose of this study was to determine whether the serum levels of the neutrophil gelatinase associated lipocalin (NGAL) molecule were important in the diagnosis and follow-up of non-complicated lower urinary tract infections. Materials and Methods: This was a cross-sectional, prospective study conducted from September 15, 2013 to April 15, 2014 in an academic emergency department. Eighty patients were enrolled in the study group and 40 healthy subjects in the control group. The patients had acute uncomplicated lower urinary tract infections with pyuria detected in a complete urinary test. All of the patients had their leukocyte, neutrophil, C-reactive protein (CRP), erythrocyte sedimentation rate, and NGAL levels evaluated before and after the treatment, and correlation among these parameters were investigated.
Results: In the study group, the plasma leukocyte, neutrophil, and CRP levels before the treatment were significantly higher compared to the aftertreatment period (p<0.001). There was no significant difference found between the before-treatment and after-treatment levels of serum NGAL (p=0.091).
Conclusion: Measuring plasma leukocyte, neutrophil, and CRP levels can support the diagnosis for urinary tract infections. However, plasma NGAL levels are not useful parameters for diagnosing non-complicated lower urinary tract infections.
Keywords
Biomarkers for Infection, Neutrophil Gelatinase Associated Lipocalin, Urinary Tract Infections
Ethical Statement
Approval for this study was granted by the Ethical Commitee of Ankara University School of Medicine, dated 25 June 2012, number 11-334-12.
References
- 1. Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2011;52:e103-120.
- 2. Grigoryan L, Trauther BW, Gupta K. Diagnosis and management of urinary tract infections in the outpatient setting: a review. JAMA. 2014;312:1677-1684.
- 3. Bolignano D, Donato V, Coppolino G, et al. Neutrophil Gelatinase - Associated Lipocalin (NGAL) as a Marker of Kidney Damage. American J Kidney Diseases. 2008;52:595-605.
- 4. Hatipoğlu S, Sevketoğlu E, Gedikbaşı A, et al. Urinary MMP-9/NGAL complex in children with acute cystitis. Pediatr Nephrol. 2011;26:1263-1268.
- 5. Decavele C, Dhondt L, De Buyzere M, et al. Increased urinary neutrophil gelatinase associated lipocalin in urinary tract infections and leukocyturia. Clin Chem Lab Med. 2011;49:999-1003.
- 6. Yılmaz A, Sevketoğlu E, Gedikbaşı A, et al. Early prediction of urinary tract infection with urinary neutrophil gelatinase associated lipocalin. Pediatr Nephrol. 2009; 24:2387-2392.
- 7. Sean M, Bennett M, Haase M, et al. Plasma and urine neutrophil gelatinaseassociated lipocalin in septic versus non-septic acute kidney injury in critical illness. Intensive Care Med. 2010;36:452-461.
- 8. Tsai H, Su P, Lee T, et al. Significant elevation and correlation of plasma neutrophil gelatinase associated lipocalin and its complex with matrix metalloproteinase-9 in patients with pelvic inflammatory disease. Clinica Chimica Acta. 2011;412:1252-1256.
- 9. Miyamoto T, Asaka R, Suzuki A, et al. Immunohistochemical detection of a spesific receptor for lipocalin 2 and its prognostic significance in endometrial carcinoma. Experimental and Molecular Pathology. 2011;91:563-568.
- 10. Hanley JA and McNeil BJ: The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1983;143:29-36.