Urinary concentration of cytokines in children with acute pyelonephritis

Eur J Pediatr. 2013 Jun;172(6):769-74. doi: 10.1007/s00431-012-1914-2. Epub 2013 Feb 7.

Abstract

Urinary tract infection (UTI) is a common bacterial infection among infants and children. Predicting which children with upper UTI will develop long-term sequelae remains difficult. We aimed at evaluating the predictive value of urine concentrations of interleukin-6 (UIL-6) and interleukin-8 (UIL-8) in subsequent renal scarring. In the current observational prospective study, urine samples for UIL-6 and UIL-8 were obtained from two groups: 31 children with first episode of febrile UTI and 22 febrile children of other origin. UIL-6 and UIL-8 were increased in children with febrile UTI, compared to children with fever of other origin [median and range (picograms per milliliter): (1) UIL-6, 74.46 (0-168) vs. 10.51 (0-47.50), respectively, p = 0.0001; (2) UIL-8, 2,660.38 (0-13,801) vs. 0, respectively, p = 0.0001]. Renal scarring was found in 5/31 (16 %) children with acute pyelonephritis. Initial median UIL-8 values were significantly higher in children with later renal scarring than in those without renal scarring [median and range (picograms per milliliter): 6,163 (2,021-13,801) vs. 1,490.5 (0-5,737), respectively, p = 0.018]. In conclusion, UIL-8 might serve as a predictive biomarker for renal scarring after an acute episode of pyelonephritis. Since UIL-8 emerges as a renal-specific diagnostic and prognostic marker, it may be suitable as a selective screening tool for children with febrile UTI.

Publication types

  • Observational Study

MeSH terms

  • Acute Disease
  • Biomarkers / urine
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cicatrix / diagnosis
  • Cicatrix / etiology*
  • Cicatrix / urine
  • Cross-Sectional Studies
  • Female
  • Fever / etiology
  • Humans
  • Infant
  • Infant, Newborn
  • Interleukin-6 / urine*
  • Interleukin-8 / urine*
  • Male
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Pyelonephritis / complications
  • Pyelonephritis / urine*

Substances

  • Biomarkers
  • Interleukin-6
  • Interleukin-8