Procalcitonin implication in renal cell apoptosis induced by acute pyelonephritis in children

Figures & data

Table 1 Characteristics of 107 patients with acute childhood pyelonephritis

	lesion	age	Sex ratio	CRP (mgL^−1)	PLA2 (IUL^−1)	PCT(μgL^−1)
4th day	Absence	43.48 ± 7.39 n = 29	M: 7%; F: 15%	77.16 ± 10.21 n = 25	29.90 ± 7.83 n = 27	2.36 ± 1.36 n = 23
	Stage > 0	44.07 ± 4.26 n = 107	M: 29%; F: 71%	114.60 ± 9.74 n = 100	72.03 ± 7.94 n = 87	7.85 ± 1.93 n = 65
	Stage I	37.91 ± 4.47 n = 72	M: 15%; F: 38%	114.60 ± 9.0 n = 66	76.32 ± 13.08 n = 57	6.40 ± 1.99 n = 47
	Stage II	48.70 ± 7.30 n = 21	M: 5%; F: 10%	130.14 ± 23.36 n = 21	32.70 ± 6.72 n = 17	7.34 ± 4.66 n = 11
	Stage III	33.47 ± 8.79 n = 14	M: 1%; F: 9%	121.07 ± 16.46n = 14	104.65 ± 28.47 n = 13	18.37 ± 9.46 n = 7
9th month	Absence	39.86 ± 6.78 n = 40	M: 17%; F: 53%	101.16 ± 12.20 n = 37	61.80 ± 12.22 n = 33	7.59 ± 3.45 n = 24
	Fibrosis (Stage I)	27.19 ± 5.54 n = 17	M: 7%; F: 23%	123.35 ± 21.35 n = 17	81.65 ± 20.38 n = 13	4.19 ± 1.03 n = 11

Table 2 Pyelonephetis progress according to procalcitonin concentration

	No sequellae	Fibrosis sequellae	F. test
Early lesion stage I–II	7.59 ± 3.45 mgL^−1 n = 24	4.19 ± 1.03 mgL^−1 n = 11	p < 0.001
	Recovery stage(0)	Aggravation stage (→I)
Early lesion stage: I	7.55 ± 4.02 mgL^−1 n = 20	3.34 ± 1.09 mgL^−1 n = 6	p < 0.001
	recovery stage (0)	Improvement stage (≥II→I)
Early lesion stage: ≥ II	7.78 ± 5.98 mgL^−1 n = 4	4.60 ± 2.36 mgL^−1 n = 5	ns

Note: The procalcitonin levels are listed according to pyelonephetis progress.

Figure 1 Receiver operating characteristics curves for C-reactive protein (CRP), phospholipase A₂ (PLa₂), procalcitonin (PCT), and renal fibrosis observed by ^99mTc-DMSA scintigraphy.

Note: Areas under curve (AUC) of the 3 markers were respectively (CI: 0.26163–0.72184) for CRP; 0.5475 (CI: 0.33059–0.76445) for PLa₂ and 0.6240 (CI: 0.42373–0.82421) for PCT.

Figure 2 Physiopathology of pyelonephritis.

Abbreviations: IL, interleukin; NO, nitric oxide; NOS, NO synthase; PCT, procalcitonin; PLA₂, phospholipase A₂; CRP, C-reactive protein; FGF, fibroblast growth factor; TNF, tumor necrosis factor.