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  • Clinical Research Article
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Diagnostic value of serum CRP, PCT and IL-6 in children with nephrotic syndrome complicated by infection: a single center retrospective study

Pediatric Research volume 95, pages 722–728 (2024)Cite this article

Abstract

Objective

The purpose was to look into the diagnostic value of serum CRP, PCT and IL-6 in children with nephrotic syndrome co-infection.

Methods

One hundred and forty-nine children with nephrotic syndrome who met the inclusion and exclusion criteria were included in this study. The children were divided into three groups: bacterial infection group, non-bacterial infection group, and non-infection group. The diagnostic value was analyzed and compared using the ROC curve.

Results

There was no statistically significant difference in the Leukocyte counts among three groups. The mean results of serum CRP, PCT and IL-6 were significantly higher in the bacterial infection group compared to those in the non-infection group (p < 0.05). AUC of CRP, PCT, IL-6 in bacterial infection were 0.791, 0.859, 0.783. The following combinations CRP + PCT + IL-6, IL-6 + PCT, CRP + PCT significantly increased the efficiency of bacterial infection diagnosis, the AUCs were 0.881, 0.884, and 0.884, respectively. AUC of PCT in non-bacterial infection was 0.663. The combinations of these three clinical indicators performed no better than PCT in ROC analysis.

Conclusion

Normal CRP or IL-6 levels do not rule out the diagnosis of bacterial infection in children on long-term glucocorticoid therapy. The appropriate combination of two or three indicators can improve the diagnostic value.

Impact

  • This study evaluated the diagnostic value of the serum concentrations of CRP, PCT and IL-6 and assessed whether the value of their combined application is better than when used alone for diagnosing primary nephrotic syndrome complicated by infection.

  • The elevation in leukocyte count cannot be used to diagnose children with nephrotic syndromes on long-term glucocorticoid treatment who have bacterial infections.

  • Normal CRP or IL-6 levels do not rule out the diagnosis of bacterial infection in children on long-term glucocorticoid therapy.

  • The appropriate combination of two or three indicators can improve diagnostic value, sensitivity, and specificity.

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Fig. 1
Fig. 2: ROC curve analysis data for CRP, PCT, IL-6 as individual indices and in combination to differentiate non-bacterial infection from non-infection.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to express their gratitude to EditSprings (https://www.editsprings.com/) for the expert linguistic services provided.

Funding

Funding

This work was supported by the Provincial Co ⁃ construction Program of Medical Science and Technique Foundation of Henan Province [201901042]; and the Young Provinces Co ⁃ construction Program of Medical Science and Technique Foundation of Henan Province [202003050].

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Authors and Affiliations

  1. Department of Pediatrics, the First Affiliated Hospital of Zhengzhou University, Clinical Center of Pediatric Nephrology of Henan Province, Zhengzhou, 450052, China

    Wanyu Jia, Wenjie Dou, Huiqin Zeng, Qin Wang, Peipei Shi, Zhen Liu, Jin Zhang & Jianjiang Zhang

  2. Department of Nephrology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China

    Jing Liu

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Contributions

Jianjiang Z. has participated in the concept and design and revising the manuscript. W.J has participated in collection of data; analysis and interpretation of data; drafting and revising the manuscript. W.D., H.Z. and Q.W. has participated in statistical analysis and interpretation of data; revising the manuscript. P.S., J.L., Z.L. and Jin.Z. have participated in revising the manuscript.

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Correspondence to Jianjiang Zhang.

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Informed consent was obtained from the parents or guardians of all study participants.

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Jia, W., Dou, W., Zeng, H. et al. Diagnostic value of serum CRP, PCT and IL-6 in children with nephrotic syndrome complicated by infection: a single center retrospective study. Pediatr Res 95, 722–728 (2024). https://doi.org/10.1038/s41390-023-02830-9

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