Is the mean platelet volume a predictive marker for the diagnosis of acute pyelonephritis in children?

Abstract

Background: Acute pyelonephritis (APN) can lead to renal scar formation, high blood pressure, and end-stage renal failure. Prompt and early diagnosis of APN is important for preventing future complications. Our goal was to study the mean platelet volume (MPV) as a predictor of APN in children.

Methods: The records of 43 patients with APN and 51 patients with a lower urinary tract infection (UTI) were investigated prospectively. APN was confirmed using radioactive nuclide 99mTc-DMSA scanning. The white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), and MPV of both groups were measured and compared.

Results: The WBC count, MPV and ESR values, and the serum concentration of CRP were higher in the APN group than in the lower UTI group (p < 0.05). In the children with APN, the optimal cut-off value for the MPV was 8.2 fl [area under the curve (AUC): 0.906], with sensitivity of 81.4 % and specificity of 86.3 %. The MPV was associated with APN (p = 0.001), and the sensitivity and specificity of the MPV for the diagnosis of APN were higher than those of the other inflammation markers. MPV > 8.2 fl yielded an adjusted OR of 7.8 (95 % CI 3.3-18.4, p < 0.001) for APN. MPV > 8.2 fl was significantly associated with late renal scar formation (adjusted OR 5.7, 95 % CI 2.3-13.8, p < 0.001).

Conclusion: The MPV is a fast and reliable measurement with considerable predictive value for the diagnosis of APN and renal scars, and its predictive capacity is better than that of CRP, ESR, and WBC values.