Urinary vanin-1 for predicting acute pyelonephritis in young children with urinary tract infection: a pilot study

Biomarkers. 2021 Jun;26(4):318-324. doi: 10.1080/1354750X.2021.1893813. Epub 2021 Mar 26.

Abstract

Background: Vanin-1, an epithelial glycosylphosphatidylolinositol (GPI)-anchored pantetheinase, is a valuable marker of renal injury.

Purpose: The aim of this study was to assess the predictive value of vanin-1 in acute pyelonephritis (APN) in comparison to the conventional serum inflammatory markers in children aged 1-24 months with the first episode of urinary tract infection (UTI).

Material and methods: Urinary vanin-1, vanin-1/Cr ratio, WBC, CRP, PCT were analysed in 58 children with febrile UTI and in 18 children with non-febrile UTI. Febrile UTI group was divided into APN subgroup (n = 29) and non-APN subgroup (n = 29), based on the results of Tc-99m-ethylenedicysteine scan.

Results: The mean vanin-1 level was higher in the APN group compared to the non-febrile UTI group (p = 0.02) and did not differ between APN and non-APN subgroup. In univariate analysis, vanin-1 (p = 0.042), CRP (p < 0.001), PCT (p < 0.001), and WBC (p = 0.022), were associated with APN, but only vanin-1 (p = 0.048) and CRP (p = 0.002) were independent markers of APN. In ROC analysis, vanin-1, with its best cut-off value of 16.53 ng/mL, had worse diagnostic profile (AUC 0.629, sensitivity 58,6%, specificity 63.8%) than CRP, PCT and WBC (AUC: 0.937; 0.880; 0.667, respectively).

Conclusions: Vanin-1 is not useful for predicting APN, since its diagnostic value is inferior to other conventional serum inflammatory markers.

Keywords: Vanin-1; acute pyelonephritis; biomarkers; children; oxidative stress; urinary tract infection.

MeSH terms

  • Acute Disease
  • Amidohydrolases / urine*
  • Biomarkers / urine*
  • Cross-Sectional Studies
  • Female
  • GPI-Linked Proteins / urine
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Pilot Projects
  • Predictive Value of Tests
  • Pyelonephritis / complications
  • Pyelonephritis / diagnosis
  • Pyelonephritis / urine*
  • ROC Curve
  • Urinary Tract Infections / complications*

Substances

  • Biomarkers
  • GPI-Linked Proteins
  • Amidohydrolases
  • pantetheinase