Predicting the development of urosepsis: predictors, techniques, technologies

Introduction. The article presents an analysis of modern approaches to predicting urosepsis development, focusing on biomarker research and diagnostic methods. The study is relevant due to the high prevalence of urosepsis, which accounts for 31.4% of all clinical forms of sepsis.

The objective was to determine the diagnostic significance and systematization of biomarkers of urosepsis in acute purulent pyelonephritis, to identify existing contradictions for further study of this problem.

Materials and methods. A systematic literature review was conducted using the PRISMA for Scoping Reviews (PRISMA-ScR) methodology, searching PubMed, Cochrane Database of Systematic Reviews, and Google Scholar with keywords: «biomarkers» OR «cytokines» OR «gene expression» OR «interleukin-6» AND «sepsis» AND «systemic inflammatory response syndrome» AND «pyelonephritis» (last search: May 30, 2025), with inclusion criteria based on PICOD: (P - population) patients with urosepsis due to acute purulent pyelonephritis; (I - intervention) prediction of urosepsis development using biomarkers; (C - comparison) patients with uncomplicated acute purulent pyelonephritis; (O - outcomes) development of sepsis in acute purulent pyelonephritis; (D - study design) prospective/retrospective cohort studies, and exclusion criteria: insufficient relevant data or interesting results, duplicate publications, uncomplicated course of acute (or exacerbation of chronic) pyelonephritis, lack of full-text version, reviews and meta-analyses, with research quality analysis conducted using the Newcastle–Ottawa Scale (NOS).

Results. A total of 39 studies involving 38,021 patients were selected, with the majority receiving more than 6 points on the Newcastle–Ottawa Scale (NOS), indicating high-quality research, and during the systematization of the obtained data, biomarkers were categorized according to the degree of their implementation in clinical practice; in terms of functionality and mechanism of action.

Conclusion. The findings of the scoping review identified reliable predictors of urosepsis development and progression, which can significantly improve the quality of diagnosis and treatment.

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