The Role of Presepsin and Neutrophil Gelatinase-Associated Lipocalin (NGAL) Levels in Pediatric Urinary Tract Infections

Objective: This study aimed to assess the utility of presepsin and neutrophil gelatinase-associated lipocalin (NGAL) levels, in serum and urine, for diagnosing urinary tract infections (UTIs) and monitoring response to treatment. By evaluating the specificity of these biomarkers for UTIs, this study sought to contribute to the existing literature. Methods: A single-center prospective study was conducted, with 32 pediatric patients diagnosed with UTIs and 32 healthy pediatric controls. Blood and urine samples were taken at the time of hospitalization and at the 72nd hour of treatment for the UTI group, and during routine clinic visits for the control group. Serum and urine levels of presepsin and NGAL were analyzed. Results: Serum and urine levels of presepsin and NGAL were significantly higher in the UTI group compared to the control group (Urine presepsin p = 0.001, others parameters p < 0.001). After 72 hours of treatment, serum presepsin and NGAL levels decreased but this difference was not statistically significant (p = 0.239 and p = 0.358). Urine levels did not show a significant decrease (p = 0.021 and p = 0.032). Receiver operating characteristic (ROC) curve analysis indicated that serum NGAL had the highest sensitivity, specificity, and predictive value for UTI diagnosis. Conclusion: Serum and urine levels of presepsin and NGAL are valuable for diagnosing UTIs. Serum presepsin and NGAL are more reliable than urine for monitoring treatment response. Among the biomarkers, serum NGAL is the most effective for both diagnosis and follow-up of UTIs.