Analysis of the Diagnostic Value of Peripheral Blood Indicators for Acute Pyelonephritis and the Influencing Factors of Poor Prognosis
Abstract
This study explored the diagnostic value of peripheral blood indices for acute pyelonephritis (APN) and the factors influencing poor prognosis.
A total of 118 patients with APN admitted to our hospital from January 2022 to June 2024 were retrospectively included as the observation group. Another 62 healthy volunteers were selected as the control group. Clinical data from the two groups were collected, and the diagnostic value of peripheral blood indices for APN was analyzed. The patients were divided according to their prognoses into good-prognosis group and poor-prognosis group, and the influencing factors of poor prognosis were identified by multivariate logistic regression analysis.
Compared to the control group, the white blood cell count (WBC) and C-reactive protein (CRP) were higher in the observation group, while IgG and C3 were lower. The areas under the curves (AUCs) of WBC, CRP, IgG, and C3 in the diagnosis of APN were 0.857, 0.846, 0.902, and 0.893, respectively, and their combined AUC was 0.981. After 3 months of follow-up, there were 43 cases of recurrence (36.44%). The multivariate logistic analysis showed that serum albumin< 35 g/L and a decrease of the IgG level were the influencing factors of poor prognosis in patients with APN.
In conclusion, WBC, CRP, IgG, and C3 had high value for the diagnosis of APN, and serum albumin< 35 g/L and the decrease of IgG level were the i factors influencing prognosis.
2. Lee A, Kim HC, Hwang SI, Chin HJ, Na KY, Chae DW, Kim S. Clinical Usefulness of Unenhanced Computed Tomography in Patients with Acute Pyelonephritis. J Korean Med Sci. 2018;33(38):e236.
3. Belyayeva M, Leslie SW, Jeong JM. Acute Pyelonephritis. 2024 Feb 28. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–.
4. Al Lawati H, Blair BM, Larnard J. Urinary Tract Infections: Core Curriculum 2024. Am J Kidney Dis. 2024;83(1):90-100.
5. Huang SY, Hsiao CH, Zhang XQ, Kang L, Yan JY, Cheng PJ. Serum procalcitonin to differentiate acute antepartum pyelonephritis from asymptomatic bacteriuria and acute cystitis during pregnancy: A multicenter prospective observational study. Int J Gynaecol Obstet. 2022;158(1):64-69.
6. Krzemień G, Pańczyk-Tomaszewska M, Górska E, Szmigielska A. Urinary vanin-1 for predicting acute pyelonephritis in young children with urinary tract infection: a pilot study. Biomarkers. 2021;26(4):318-324.
7. Gong X, He S, Luo L, Ding C, Qin X, Yuan Y, et al. The preliminary study of delta checks for immunoglobulins and complements in the clinical laboratory. Ann Clin Biochem. 2024 Sep 24:45632241287135. doi: 10.1177/ 00045632241287135. Epub ahead of print. PMID: 39261111.
8. Chen K, Deng Y, Shang S, Tang L, Li Q, Bai X, et al. Complement factor B inhibitor LNP023 improves lupus nephritis in MRL/lpr mice. Biomed Pharmacother. 2022;153:113433.
9. Expert Panel on Urological Imaging; Smith AD, Nikolaidis P, Khatri G, Chong ST, De Leon AD, et al. ACR Appropriateness Criteria® Acute Pyelonephritis: 2022 Update. J Am Coll Radiol. 2022;19(11S):S224-S239.
10. Song L, Liang EY, Wang HM, Shen Y, Kang CM, Xiong YJ, et al. Differential diagnosis and prospective grading of COVID-19 at the early stage with simple hematological and biochemical variables. Diagn Microbiol Infect Dis. 2021;99(2):115169.
11. Ali S, Zehra A, Khalid MU, Hassan M, Shah SIA. Role of C-reactive protein in disease progression, diagnosis and management. Discoveries (Craiova). 2023;11(4):e179.
12. Fang NW, Chiou YH, Chen YS, Hung CW, Yin CH, Chen JS. Nomogram for diagnosing acute pyelonephritis in pediatric urinary tract infection. Pediatr Neonatol. 2022;63(4):380-387.
13. Wu HH, Crames M, Wei Y, Liu D, Gueneva-Boucheva K, Son I, et al. Effect of the ADCC-Modulating Mutations and the Selection of Human IgG Isotypes on Physicochemical Properties of Fc. J Pharm Sci. 2022 Sep;111(9):2411-2421.
14. Wöhner M, Nimmerjahn F. Cytotoxic IgG: Mechanisms, functions, and applications. Immunity. 2025 Jun 10;58(6):1378-1395.
15. Yang X, Tang X, Li T, Man C, Yang X, Wang M, et al. Circulating follicular T helper cells are possibly associated with low levels of serum immunoglobulin G due to impaired immunoglobulin class-switch recombination of B cells in children with primary nephrotic syndrome. Mol Immunol. 2019;114:162-170.
16. Walker MR, Eltahla AA, Mina MM, Li H, Lloyd AR, Bull RA. Envelope-Specific IgG3 and IgG1 Responses Are Associated with Clearance of Acute Hepatitis C Virus Infection. Viruses. 2020 Jan 8;12(1):75.
17. Hale G, Davy AD, Wilkinson I. Systematic analysis of Fc mutations designed to enhance binding to Fc-gamma receptors. MAbs. 2024 Jan-Dec;16(1):2406539.
18. Lee JL, Mohamed Shah N, Makmor-Bakry M, Islahudin FH, Alias H, Noh LM, et al. A Systematic Review and Meta-regression Analysis on the Impact of Increasing IgG Trough Level on Infection Rates in Primary Immunodeficiency Patients on Intravenous IgG Therapy. J Clin Immunol. 2020 Jul;40(5):682-698.
19. Dalakas MC. Update on Intravenous Immunoglobulin in Neurology: Modulating Neuro-autoimmunity, Evolving Factors on Efficacy and Dosing and Challenges on Stopping Chronic IVIg Therapy. Neurotherapeutics. 2021 Oct;18(4):2397-2418.
20. Yang H, Wu K, Zhang H, Owyang Q, Miao Y, Gu F, et al. IgA, albumin, and eosinopenia as early indicators of cytomegalovirus infection in patients with acute ulcerative colitis. BMC Gastroenterol. 2020 Sep 5;20(1):294.
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| Issue | Articles in Press | |
| Section | Brief Communication | |
| Keywords | ||
| Acute pyelonephritis C-reactive protein Diagnosis White blood cell count | ||
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