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J Pediatr Infect Dis 2022; 17(03): 155-162
DOI: 10.1055/s-0042-1748922
Original Article

Diagnostic Value of Urine Ribonuclease 7 (RNase 7) to Creatinine Ratio for Detecting Urinary Tract Infection in Children with Pyuria

Authors

  • Nuran Cetin 

    1   Department of Pediatric Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey

  • Zeynep Kusku Kiraz 

    2   Department of Biochemistry, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey

  • Aylin Gencler 

    1   Department of Pediatric Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey

Funding None.
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Abstract

Objective Ribonuclease 7 (RNase 7) is one of the members of the antimicrobial peptides playing a role in maintaining urinary tract sterility. We aimed to investigate the predictive value of the urine RNase 7 levels in children with pyuria and associations between RNase 7 and vesicoureteral reflux (VUR) and renal scarring.

Methods This study included 109 children with pyuria (46 febrile urinary tract infections [UTIs], 38 nonfebrile UTIs, and 25 sterile pyuria) whose RNase 7 levels were measured by enzyme-linked immunoassay. The results for urine RNase 7 concentrations were expressed as micrograms per milligrams creatinine.

Results RNase 7/Cr levels were higher in patients with both febrile and nonfebrile UTIs than the patients with sterile pyuria (p = 0.001). RNase 7/Cr had predictive values of diagnosis of febrile and nonfebrile UTIs (cut-off value: 2.92 µg/mg, p = 0.003; cut-off value: 3.67 µg/mg, p < 0.001, respectively). RNase 7/Cr had higher levels in the patients with VUR than without VUR (cut-off value: 4.28 µg/mg, p = 0.037). The patients with renal scarring had higher urine RNase 7/Cr than those without scarring (cut-off value: 4.54 µg/mg, p = 0.041).

Conclusion The evaluation of RNase 7/Cr may help prevent unnecessary and/or inappropriate antibiotic use in children with pyuria. The higher RNase 7 levels in patients with VUR and renal scarring may reflect long-term inflammation or greater inflammatory response during acute infection.

Keywords

children - renal scarring - ribonuclease 7 - urinary tract infection - vesicoureteral reflux


Publication History

Received: 23 December 2021

Accepted: 29 March 2022

Article published online:
10 June 2022

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