Association of Neutrophil Gelatinase associated Lipocalin and Leukocyte Differential Count in Children with Febrile Urinary Tract Infections

Abstract

Purpose: To investigate the association between urinary neutrophil gelatinaseassociated lipocalin (uNGAL) and leukocyte differential count in children with urinary tract infections (UTIs). Methods: A retrospective chart review was performed in children undergoing uNGAL measurements between June 2018 and September 2019. Patients with suspected or diagnosed UTIs were included. The relationship between uNGAL and blood leukocyte differential count was investigated in children. Results: A total of 197 children were included in this study, 119 of whom (60%) had UTIs. The non-UTI patients (n=78) were diagnosed with pneumonia, acute gastroenteritis, viral upper respiratory infection, and others. After adjusting for age, gender, and fever duration, the leukocyte count, monocyte count, and uNGAL levels were higher in the UTI group than in the non-UTI group (P <0.05). uNGAL showed positive correlations with neutrophil counts, monocyte counts, the neutrophil-to-lymphocyte ratio, and the monocyte-to-lymphocyte ratio in the UTI group (P <0.05). uNGAL levels were only associated with the neutrophil-tolymphocyte ratio in the non-UTI group (P <0.05). In a multivariable logistic regression analysis, only uNGAL was associated with the presence of UTI (P <0.05). The area under the receiver operating characteristic curves for uNGAL and monocyte counts to identify UTI were 0.89 (95% confidence interval (CI): 0.824–0.939; P = 0.025) and 0.7 (95% CI: 0.627–0.774; P =0.038), respectively. Conclusions: In children with UTIs, uNGAL levels may be associated with blood leukocyte differential counts. uNGAL measurements and monocyte counts can be helpful in children with suspected UTIs.