Ankara Med J. 2020; 20(4): 895-903 | DOI: 10.5505/amj.2020.22438

Üriner Sistem Enfeksiyonu Olan Çocuklarda Üst Üriner Sistem Enfeksiyonunun Ayýrt Edilmesinde CRP/Albümin Oranýnýn Kullanýlmasý

Hatice Güneþ, Meliha Kütükçü
Kahramanmaraþ Sütçü Imam Üniversitesi, Týp Fakültesi, Pediatri Anabilim Dalý

GÝRÝÞ ve AMAÇ: Ýdrar yolu enfeksiyonlarý (ÝYE) çocukluk çaðýnda sýk görülen enfeksiyonlardýr. Enfeksiyonun seyri ve klinik takibi lokalizasyonuna göre (alt ve üst) deðiþir. C-reaktif protein (CRP) albümin oraný (CAO), son yýllarda kullanýlan enflamatuar belirteçlerden biridir. Çalýþmamýzýn amacý CAO kullanarak bu ayrýmý araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Bu çalýþma, ÝYE tanýsý almýþ 95 çocuðun hasta dosyalarý taranarak gerçekleþtirildi. Hastalar enfeksiyon bölgesine göre üst ÝYE (Ü-ÝYE) ve alt ÝYE (A-ÝYE) olarak iki gruba ayrýldý. Hastalarýn laboratuvar ve demografik özellikleri hastane kayýtlarýndan elde edilmiþ ve gruplar arasýnda karþýlaþtýrýlmýþtýr.
BULGULAR: CAR, Ü-ÝYE grubunda anlamlý olarak daha yüksekti (p <0,001). Alýcýnýn çalýþma karakteristik eðrisine göre, Ü-ÝYE tahmini için CAO'nýn optimal kesme deðeri>% 97 özgüllüðü ve% 53 duyarlýlýðý olan> 12,65 idi (AUC = 0,864; % 95 güven aralýðý CI: 0,792– 0,9363, LR: 24,40; p <0,001). Univaryant analizde anlamlý bulunan ve Ü-ÝYE ile korele olan deðiþkenlerin de alýnarak yapýldýðý çok deðiþkenli lojistik regresyon analizinde CAO (OR = 0,897,% 95 CI: 0,838-0,960, p = 0,002) ve mutlak nötrofil sayýsýnýn (OR = 0,182,% 95 CI: 0,039-0,841, p = 0,029) halen anlamlý olduðu bulundu.
TARTIÞMA ve SONUÇ: CAO, ÝYE'de Ü-ÝYE ile baðýmsýz olarak iliþkilidir ve Ü-ÝYE'yi tahmin etmek için yararlý olabilir.

Anahtar Kelimeler: Albümin, C reaktif protein, çocuk, piyelonefrit, idrar yolu enfeksiyonu

---

Use of CRP/Albumin Ratio In The Differentiation of Upper Urinary System Infection In Children With A Urinary System Infection

Hatice Güneþ, Meliha Kütükçü
Kahramanmaraþ Sütçü Imam University, Medical Faculty, Department Of Pediatrics

INTRODUCTION: Urinary tract infections (UTI) are common infections in childhood. The course of infection and its clinical follow-up vary according to its localization (lower vs. upper). C-reactive protein (CRP) albumin ratio (CAR) is one of the inflammatory markers that have been used in recent years. The purpose of our study is to investigate this distinction by using CAR.
METHODS: This study was conducted by scanning the patient files of 95 children diagnosed with UTI. The patients were divided into two groups according to the infection site as upper UTI (UUTI) and lower UTI (LUTI). Laboratory and demographic features of the patients were obtained from the hospital records and compared between the groups.
RESULTS: CAR was significantly greater in the UUTI group (p<0.001). According to receiver operating characteristic curve, the optimal cut-off value of CAR for prediction of UUTI was >12.65, which had a specificity of 97% and sensitivity of 53% (AUC = 0.864; 95% confidence interval CI: 0.792–0.9363, LR: 24.40; p < 0.001). In the multivariate logistic regression analysis, in which variables found to be significant in univariate analysis and correlated with UUTI were also taken, CAR (OR = 0.897, 95% CI: 0.838-0.960, p = 0.002) and absolute neutrophil count (OR = 0.182, 95% CI: 0.039 -0.841, p = 0.029) was still found to be significant.
DISCUSSION AND CONCLUSION: CAR is independently related to UUTI in UTI and may be useful to predict UUTI.

Keywords: Albumin, C reactive protein, children, pyelonephritis, urinary tract infection

---

ATIF KOPYALA