The role of heparin binding protein and neutrophil gelatinase associated lipocalin in urinary tract infections diagnosis

Urinary tract infection (UTI) is one of the most common infections in children and may progress with ambiguous findings. Localization of infection is important for treatment and prognosis. UTI is a disease that is carried from childhood to adulthood, has high morbidity and tends to recur, and its progression to chronic kidney disease is preventable. The aim of our study is to prevent unnecessary diagnoses in UTI, to diagnose quickly and accurately, and to develop new parameters to diagnose UTI earlier. After ethics committee approval, urine culture, white blood cell count, neutrophil count, C Reactive Protein, procalcitonin, pyuria, leukocyte esterase, urea, creatinine values, urinary Heparin Binding Protein (HBP) and urinary Neutrophil Gelatinase Associated Lipocalin (NGAL) parameters that between 55 patients with urinary tract infection symptoms and 25 patients without UTI symptoms who between the ages of 3 months and 5 years who applied to our hospital, were compared. In our study, urinary NGAL and HBP values ​​were found to be higher in the patient group than in the control group. NGAL level was significantly higher than the control group (151.77 ng/ml vs. 75.46 ng/ml, p <0.001). We found that for urine culture positivity in the diagnosis of UTI, the uNGAL variable showed 90.6% sensitivity and 66.7% specificity at a threshold value of 115.8 ng/ml. The mean difference between urinary HBP values ​​was also statistically significant (16.61 ng/ml vs. 7.6 ng/ml, p <0.001). We found that for urine culture positivity in the diagnosis of UTI, the urinary HBP variable showed 100% sensitivity and 52% specificity at a cut-off value of 14.1 ng/ml. In conclusion, early diagnosis of UTI and initiation of treatment are extremely important in terms of chronic complications. In our study, urinary NGAL and HBP were found to be diagnostic parameters in acute UTI.