Urinary Interleukin 6 and 8 Concentrations in Children with Acute Pyelonephritis, before and after Treatment

Urinary tract infections (UTI) are common cause of morbidity and mortality especially in young children around the world. Pyelonephritis can lead to scar formation, and subsequent hypertension and renal failure. Interleukins play a major role in renal scar formation following febrile pyelonephritis. The aim of this study was to investigate the level of urinary interleukin-6 (UIL-6) and UIL-8 concentrations during the acute phase of pyelonephritis and after two kinds of treatment.

UIL-6 and UIL-8 concentrations were determined by enzyme immunoassay in 34 children with acute pyelonephritis who were treated with Ceftriaxone plus steroids (case group) and in 20 patients treated with antibiotic alone (control group). Cases and controls were age and sex matched. Urine samples were obtained at the time of presentation prior to drug administration and at follow-up 72 hours after initiation of medication. Creatinine concentrations were also determined, and cytokine/creatinine ratios were calculated.

The differences between the cytokine/creatinine ratios in the initial urine samples and the follow-up samples were significant in the case group (p<0.001), but not for the controls. In addition, combined antibiotic and steroids significantly decreased UIL-6 and UIL-8 concentrations compared with antibiotic alone (p<0.05).

We conclude that steroids combined with antibiothics significantly decrease UIL-6 and UIL-8 levels in patients with acute pyelonephritis. This result can suggest that the clinical use of corticosteroids may prevent scar formation following pyelonephritis.