High sensitive C-reactive protein: a new marker for urinary tract infection, VUR and renal scar

摘要

BACKGROUND: Accurate diagnosis and early treatment of urinary tract infections (UTS) are important because of its association with renal scarring (RS).AIMS: To investigate the serum levels of fl-bronectin, high sensitive CRP (Hs-CRP), urinary fibronectin, and beta-2 microgiobulin (beta2MG) levels in patients with UTI and relationship of these parameters with VUR (vesicoureteral reflex) and RS.PATIENTS AND METHODS: 72 patients were included in study and divided into three groups: Group I (20 patients with first UTS); Group II (16 patients with recurrent UTI with VUR); Group f!i (16 patients without UTI with VUR).RESULTS: Serum and urine fibronectin levels were similar in all study groups and controls. Urinary beta2MG levels were higher in Group I! (302±179 ng/ml) than in the Group I (134±90 ng/ml) (p < 0.001). Moreover, beta2WIG levels were similar in Group El (302+179 ng/ml) and group HI (218+147 ng/ml). By contrast, beta2MG levels were higher in Group III (218+147 ng/ml) than in the controls (64+32 ng/ml) (p < 0.001). Hs-CRP levels were higher in Group I (1.8+2.7 mg/L), Group I! (23.1 ±32 mg/L), and II! (0.4±0.1 mg/L) than the controls (0.2+0.08 mg/L) (p < 0.001). Hs-CRP levels were higher in Group I! (23.1+31.9 mg/L) than in the Group I (1.8+2.7 mg/L) (p < 0.001). Hs-CRP levels were higher in Group I (1.8+2.7 mg/L) and Group I! (23.1+31.9 mg/L) than in the Group HI (0.4+0.1 mg/L) (p < 0.001). Hs-CRP levels were higher in group HI (0.37±0.17 mg/L) than in the controls (0.2±0.08 mg/L) (p < 0.001). Hs-CRP (18.8+25 mg/L) and beta2MG levels (349.4+128.5 ng/ml) were different in UTI with RS from the controls (0.2+0.08 mg/L and 64±32 ng/ml respectively, p < 0.001). Fibronectin levels were similar in patients with and without RS.CONCLUSIONS: Increased urinary beta2MG and Hs-CRP were observed in initial UTi and recurrent UTI with VUR, Fibronectin levels were not useful for detection of first and recurrent UTI with VUR and RS. Elevated Hs-CRP levels can help us predetermine the patients with VUR prone to proceed to clinical chronic renal failure.