Could Serum Copeptin Be Used for Diagnosing Urinary Tract Infections in Children?

Yıl 2022, Cilt: 13 Sayı: 45, 12 - 17, 07.04.2022

Mervan Bekdas , Mustafa Erkocoglu , Şeyda Karabörk , Mustafa Dilek

Öz

Objective: Early diagnosis of urinary tract infection (UTI) is important to reduce short- and long-term complications. To this end, effective biomarkers are needed. Our aim was to evaluate the role of copeptin in the diagnosis of UTI and in distinguishing upper from lower UTI compared to other inflammatory markers.
Methods: The diagnosis of UTI was based on the presence of typical clinical symptoms and a positive urine culture. The control group was formed by healthy children without signs or symptoms of infection. Complete blood count, CRP, ESR, serum IL -6, NGAL and copeptin were evaluated.
Results: The study group included 41 patients with UTI and 41 healthy controls. The patients were 5 (0.8-15) years old and 65.9% of them were female. In the patients with UTI, in addition to total WBC (p<0.001) and NGAL (p=0.031), copeptin was also increased (147.9(60.8-361.9) vs. 69.7(24.2-303) ng/ml, p<0.001). Copeptin could diagnose UTI at a cut-off value of 81.8 ng/ml (p<0.001, sensitivity 80.4%, specificity 60.5%). Within the UTI group, 10 had upper UTI and 31 had lower UTI. In the upper UTI group WBC (p=0.019), CRP (p<0.001), ESR (p<0.001) and NGAL (p=0.046) were higher. Copeptin did not differ between upper and lower UTI groups (p=0.82). Copeptin correlated with IL -6 and NGAL (r²=0.23, p=0.002; r²=0.89, p<0.001, respectively).
Conclusion: Copeptin is a useful biomarker to use in the diagnosis of childhood UTI, but more comprehensive studies are needed to evaluate its role in distinguishing upper from lower UTI.

Anahtar Kelimeler

Copeptin, UTI, NGAL, IL-6, Child

Destekleyen Kurum

Abant Izzet Baysal University Scientific Research Foundation

Proje Numarası

2015.8.23.965

Serum Copeptin Çocukluk Çağı İdrar Yolu Enfeksiyonlarının Tanısında Kullanılabilir mi?

Öz

Amaç: Üriner sistem enfeksiyonu (ÜSE)’nin erken teşhis edilmesi kısa ve uzun dönem etkileri azaltmak için önemlidir. Bu amaçla etkili biyobelirteçlere ihtiyaç vardır. Bu çalışmada, copeptinin diğer inflamatuvar belirteçlere göre ÜSE tanısında ve alt-üst ÜSE ayırımında rolünü değerlendirmeyi amaçladık.
Yöntem: ÜSE tanısı, tipik klinik semptomlar ve pozitif idrar kültürüne dayanılarak konuldu. Kontrol grubu enfeksiyon bulgusu olmayan sağlıklı çocuklardan oluşturuldu. Hastaların tam kan sayımı, CRP, sedimentasyon, serum IL-6, NGAL ve copeptin düzeyleri değerlendirildi.
Bulgular: Çalışmaya 41'er tane ÜSE ve sağlıklı birey dahil edildi. Hastaların yaşları 5 (0.8-15) yıl olup, %65.9’u kadın idi. ÜSE’si olanlarda WBC (p<0.001) ve NGAL (p=0.031) yanında copeptin (147.9(60.8-361.9) vs. 69.7(24.2-303) ng/ml, p<0.001) seviyeleri anlamlı oranda yüksekti. Copeptinin 81.8 ng/ml cut-off değeri ÜSE'ye işaret etmekteydi (sensitivite %80.4, spesifite %60.5, p<0.001). ÜSE grubunun 10 tanesi üst, 31 tanesi de alt ÜSE tanısına sahipti. Üst ÜSE hastalarında WBC (p=0.019), CRP (p<0.001), sedimentasyon (p<0.001) ve NGAL (p=0.046) seviyeleri anlamlı oranda yüksekti. Copeptin üst ve alt ÜSE grupları arasında farklılık göstermemekteydi. Copeptin IL-6 ve NGAL ile ilişkili bulundu (sırasıyla r²=0.23, p=0.002; r²=0.89, p<0.001).
Sonuç: Copeptin çocukluk çağı ÜSE tanısında kullanılabilecek faydalı bir biyobelirteçtir, ancak üst ve alt ÜSE ayrımdaki rolünü değerlendirmek için daha kapsamlı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Copeptin, NGAL, IL-6, İdrar Yolu Enfeksiyonu, Çocuk

Proje Numarası

2015.8.23.965

Kaynakça

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