Predictive Value of D-dimer in Children with Acute Pyelonephritis

Abstract

Background: The diagnosis of acute febrile urinary tract infection (UTI) relies on various clinical and laboratory findings, which have shown conflicting results. Objectives: This study aimed to evaluate the utility of serum D-dimer in distinguishing acute pyelonephritis (APN) from other acute bacterial febrile infections. Methods: This cross-sectional study included 47 children with a confirmed UTI (verified by positive urine culture) and 47 children with other bacterial febrile infections. Serum D-dimer levels were measured in all patients before starting antibacterial treatment. Results: A total of 94 febrile children were evaluated, with females outnumbering males. Significant differences between the two groups were observed for microscopic hematuria (P = 0.044), bacteriuria (P < 0.001), white blood cell (WBC) count (P = 0.047), and hemoglobin (Hgb) (P = 0.035), but not for serum D-dimer (P = 0.327). Binary logistic regression analysis revealed that Hgb (P = 0.019) had a significant predictive value in APN, whereas serum D-dimer did not. Serum D-dimer was found to be an inaccurate biomarker for distinguishing febrile UTI from other bacterial febrile infections. Conclusions: Based on our findings, while D-dimer level increase in various acute bacterial febrile infections, they are not appropriate in differentiating febrile UTI from other bacterial infections.