predictive value of d-dimer in children with acute pyelonephritis

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.