{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:21:38Z","timestamp":1791181298195,"version":"4.1.0"},"reference-count":39,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,5,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVE:<\/jats:title>\n                  <jats:p>Urinary tract infections (UTIs) are common childhood bacterial infections that may involve renal parenchymal infection (acute pyelonephritis [APN]) followed by late scarring. Prompt, high-quality diagnosis of APN and later identification of children with scarring are important for preventing future complications. Examination via dimercaptosuccinic acid scanning is the current clinical gold standard but is not routinely performed. A more accessible assay could therefore prove useful. Our goal was to study procalcitonin as a predictor for both APN and scarring in children with UTI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>A systematic review and meta-analysis of individual patient data were performed; all data were gathered from children with UTIs who had undergone both procalcitonin measurement and dimercaptosuccinic acid scanning.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>A total of 1011 patients (APN in 60.6%, late scarring in 25.7%) were included from 18 studies. Procalcitonin as a continuous, class, and binary variable was associated with APN and scarring (P &amp;lt; .001) and demonstrated a significantly higher (P &amp;lt; .05) area under the receiver operating characteristic curve than either C-reactive protein or white blood cell count for both pathologies. Procalcitonin \u22650.5 ng\/mL yielded an adjusted odds ratio of 7.9 (95% confidence interval [CI]: 5.8\u201310.9) with 71% sensitivity (95% CI: 67\u201374) and 72% specificity (95% CI: 67\u201376) for APN. Procalcitonin \u22650.5 ng\/mL was significantly associated with late scarring (adjusted odds ratio: 3.4 [95% CI: 2.1\u20135.7]) with 79% sensitivity (95% CI: 71\u201385) and 50% specificity (95% CI: 45\u201354).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Procalcitonin was a more robust predictor compared with C-reactive protein or white blood cell count for selectively identifying children who had APN during the early stages of UTI, as well as those with late scarring.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2012-2408","type":"journal-article","created":{"date-parts":[[2013,4,30]],"date-time":"2013-04-30T00:54:59Z","timestamp":1367283299000},"page":"870-879","source":"Crossref","is-referenced-by-count":96,"title":["Association of Procalcitonin With Acute Pyelonephritis and Renal Scars in Pediatric UTI"],"prefix":"10.1542","volume":"131","author":[{"given":"Sandrine","family":"Leroy","sequence":"first","affiliation":[{"name":"Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom;"},{"name":"Epidemiology of Emerging Disease Unit, Institut Pasteur, Paris, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Fernandez-Lopez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Joan de Deu Hospital, Barcelona, Spain;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roya","family":"Nikfar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Abuzar Children Medical Center Hospital, Ahvaz, Iran;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Romanello","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Udine, Udine, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Bouissou","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children's Hospital, Paul Sabathier University, CHU Purpan, Toulouse, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Gervaix","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Metin K.","family":"Gurgoze","sequence":"additional","affiliation":[{"name":"Firat University Medicine Faculty, Department of Pediatrics, Division of Pediatric Nephrology, Elaz\u0131\u011f, Turkey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Bressan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Padova, Padova, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladislav","family":"Smolkin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medical Center, Afula, Israel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Tuerlinckx","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Cliniques Universitaires de Mont-Godinne, Universit\u00e9 Catholique de Louvain, Yvoir, Belgium;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constantinos J.","family":"Stefanidis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u2018\u2018P. and A. Kyriakou\u2019\u2019 Children\u2019s Hospital, Athens, Greece;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgos","family":"Vaos","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Alexandroupolis University Hospital, Democritus University of Thrace School of Medicine, Thrace, Greece;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Leblond","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Jeanne de Flandre Hospital, Lille, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firat","family":"Gungor","sequence":"additional","affiliation":[{"name":"Akdeniz University, School of Medicine, Department of Nuclear Medicine, Antalya, Turkey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Gendrel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics of Necker Hospital, Paris-Descartes University, Paris, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Chalumeau","sequence":"additional","affiliation":[{"name":"Department of Pediatrics of Necker Hospital, Paris-Descartes University, Paris, France; and"},{"name":"Inserm U953 Unit, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2013,5,1]]},"reference":[{"issue":"5","key":"2021120900072548200_B1","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/j.1651-2227.1998.tb01502.x","article-title":"Incidence rate of first-time symptomatic urinary tract infection in children under 6 years of age.","volume":"87","author":"M\u00e5rild","year":"1998","journal-title":"Acta Paediatr"},{"issue":"7113","key":"2021120900072548200_B2","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1136\/bmj.315.7113.905","article-title":"New renal scarring in children who at age 3 and 4 years had had normal scans with dimercaptosuccinic acid: follow up study.","volume":"315","author":"Vernon","year":"1997","journal-title":"BMJ"},{"issue":"5","key":"2021120900072548200_B3","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1681\/ASN.2007020245","article-title":"Vesicoureteral reflux.","volume":"19","author":"Williams","year":"2008","journal-title":"J Am Soc Nephrol"},{"issue":"5 pt 2","key":"2021120900072548200_B4","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1016\/S0022-5347(17)37014-3","article-title":"Dimercaptosuccinic acid renal scintigraphy for the evaluation of pyelonephritis and scarring: a review of experimental and clinical studies.","volume":"148","author":"Rushton","year":"1992","journal-title":"J Urol"},{"issue":"8844","key":"2021120900072548200_B5","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/0140-6736(93)90277-N","article-title":"High serum procalcitonin concentrations in patients with sepsis and infection.","volume":"341","author":"Assicot","year":"1993","journal-title":"Lancet"},{"issue":"2","key":"2021120900072548200_B6","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1086\/421997","article-title":"Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis.","volume":"39","author":"Simon","year":"2004","journal-title":"Clin Infect Dis"},{"issue":"10","key":"2021120900072548200_B7","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1515\/CCLM.2008.282","article-title":"Is serum procalcitonin able to predict long-term kidney morbidity from urinary tract infections in children?","volume":"46","author":"Zaffanello","year":"2008","journal-title":"Clin Chem Lab Med"},{"issue":"6","key":"2021120900072548200_B8","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1016\/j.jpeds.2009.06.037","article-title":"Serum procalcitonin for prediction of renal parenchymal involvement in children with urinary tract infections: a meta-analysis of prospective clinical studies.","volume":"155","author":"Mantadakis","year":"2009","journal-title":"J Pediatr"},{"issue":"8842","key":"2021120900072548200_B9","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/0140-6736(93)93004-K","article-title":"Meta-analysis of the literature or of individual patient data: is there a difference?","volume":"341","author":"Stewart","year":"1993","journal-title":"Lancet"},{"key":"2021120900072548200_B10","unstructured":"Centre for Review Dissemination. 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