Top

Published in:

01-10-2005 | Original Article

Proinflammatory cytokines and procalcitonin in children with acute pyelonephritis

Authors: Metin Kaya Gürgöze, Saadet Akarsu, Erdal Yilmaz, Ahmet Gödekmerdan, Zehra Akça, Ismail Çiftçi, A. Denizmen Aygün

Published in: Pediatric Nephrology | Issue 10/2005

Abstract

This prospective study, performed in 76 children with a urinary tract infection (UTI), evaluates the diagnostic value of procalcitonin (PCT) and proinflammatory cytokines (IL-1β, IL-6 and TNF-α) in children with acute pyelonephritis documented by dimercaptosuccinic acid scintigraphy (DMSA). Renal parenchymal involvement was assessed by ^99mTc-DMSA scintigraphy within 7 days of admission. The diagnosis of acute pyelonephritis was confirmed only in patients with reversible lesions on scintigraphy. According to DMSA scan results, patients were divided into two groups, lower UTI or acute pyelonephritis. In acute pyelonephritis, serum PCT level was found to be significantly higher than it is in the lower UTI (p <0.001). Also, significantly higher serum proinflammatory cytokines (IL-1β, IL-6 and TNF-α) levels were detected in those with acute pyelonephritis than those with lower UTI (p <0.001). We conclude that both serum PCT and proinflammatory cytokine levels may be used as accurate markers for diagnosis of acute pyelonephritis.

Sirin A, Emre S, Alpay H, Nayir A, Bilge I, Tanman F(1995) Etiology of chronic renal failure in Turkish children. Pediatr Nephrol 9:549–552CrossRefPubMed

Hoberman A, Chao H-P, Keller DM, Hickey R, Davis HW, Ellis DE (1993) Prevalence of urinary tract infection in febrile infants. J Pediatr 123:17–23PubMed

Cornu C, Cochat P, Collet J-P, Delair S, Haugh MC, Rolland C, and the GEP (1994) Survey of the attitudes to management of acute pyelonephritis in children. Pediatr Nephrol 8:275–277CrossRefPubMed

Abbas AK, Lichtman AH, Pober JS (1997) Cellular and molecular immunology, 3rd edn. Saunders, Philadelphia, USA, pp 250–276

Curfs J, Meis M, Hoogkamp-Korstanje A (1997) A primer on cytokines: Sources, receptors, effects, and inducers. J Clin Microbiol 10:742–780

Assicot M, Gendrel D, Carsin H, Raymond J, Guilbaud J, Bohoun C (1993) High serum procalcitonin concentration in patients with sepsis and infection. Lancet 341:515–518CrossRefPubMed

Karsai W, Oberholffer M, Meier-Hellman A, Reinhart K (1997) Procalcitonin—a new indicator of systemic response to severe infections. Infection 25:329–334CrossRefPubMed

Rushton HG (1997) The evaluation of acute pyelonephritis and renal scarring with technetium 99m-dimercaptosuccinic acid renal scintigraphy: evolving concepts and future directions. Pediatr Nephrol 11:108–120CrossRefPubMed

Benador D, Benador N, Slosman DO, Nussle D, Mermillod B, Girardin E (1994) Cortical scintigraphy in the evaluation of renal parenchymal changes in children with pyelonephritis. J Pediatr 124:17–20PubMed

10.

Stokland E, Hellstorm M, Jacobsson B, Jodat U, Sixt R (1996) Renal damage one year after first urinary tract infection: role of dimercaptosuccinic acid scintigraphy. J Pediatr 129 815–820

11.

Goldraich NP, Ramos OL, Goldraich JH (1995) Urography versus DMSA scan in children with vesicoureteric reflux. Pediatr Nephrol 9:221–226CrossRefPubMed

12.

Goldraich NP, Goldraich JH (1995) Update on dimercaptosuccinic acid renal scanning in children with urinary tract infection. Pediatr Nephrol 9:221–226CrossRefPubMed

13.

Lin KY, Chiu NT, Chen MJ, Lai CH, Huang JJ, Wang YT, Chiou YY (2003) Acute pyelonephritis and sequelae of renal scar in pediatric first febrile urinary tract infection. Pediatr Nephrol 18:362–365PubMed

14.

Smolkin V, Koren A, Raz R, Colodner R, Sakran W, Halevy R (2002) Procalcitonin as marker of acute pyelonephritis in infants and children. Pediatr Nephrol 17:409–412CrossRefPubMed

15.

Prat C, Dominguez J, Rodrigo C, Gimenez M, Azuara M, Jimenez O, Gali N, Ausina V (2003) Elevated serum procalcitonin values correlate with renal scarring in children with urinary tract infection. Pediatr Infect Dis J 22:438–442CrossRefPubMed

16.

Roilides E, Papachristou F, Gioulekas E, Tsaparidou S, Karatzas N, Sotiriou J, Tsiouris J (1999) Increased urine interleukin-6 concentrations correlate with pyelonephritic changes on 99m Tc-Dimercaptosuccinic acid scans in neonates with urinary tract infections. J Infect Dis 180:904–907CrossRefPubMed

17.

Otto G, Braconier JH, Andreason A, Svanborg C (1999) Interleukin-6 and disease severity in patients with bacteremic and nonbacteremic febrile urinary tract infection. J Infect Dis 179:172–179CrossRefPubMed

18.

Benson M, Jodal U, Andreasson A, Karlsson A, Rydberg J, Svanborg C (1994) Interleukin 6 response to urinary tract infection in childhood. Pediatr Infect Dis J 13:612–616PubMed

19.

Benson M, Jodal U, Agace W, Hellstrom M, Marild S, Rosberg S, Sjostrom M, Wettergren B, Jonsson S, Svanborg C (1996) Interleukin-6 and IL-8 in children with febrile urinary tract infection and asymptomatic bacteriuria. J Infect Dis 174:1080–1084PubMed

20.

Lin SJ, Huang JL (1998) Circulating interleukin (IL)-1 beta, Il-6 and tumor necrosis factor-alpha in children with febrile infection-a comparison with C-reactive protein. Asian Pac J Allergy Immunol 16:105–109PubMed

21.

Tang RB, Lee BH, Chung RL, Chen SJ, Wong TT (2001) Interleukin-1 beta and tumor necrosis factor-alpha in cerebrospinal fluid of children with bacterial meningitis. Childs Nerv Syst 17:453–456CrossRefPubMed

22.

Prio TK, Bruunsgaard H, Roge B, Pedersen K (2002) Asymptomatic bacteriuria in elderly humans is associated with increased levels of circulating TNF receptors and elevated numbers of neutrophils. Exp Gerontol 37:693–699CrossRefPubMed

Title: Proinflammatory cytokines and procalcitonin in children with acute pyelonephritis
Authors: Metin Kaya Gürgöze
Saadet Akarsu
Erdal Yilmaz
Ahmet Gödekmerdan
Zehra Akça
Ismail Çiftçi
A. Denizmen Aygün
Publication date: 01-10-2005
Publisher: Springer-Verlag
Published in: Pediatric Nephrology / Issue 10/2005
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-005-1941-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Proinflammatory cytokines and procalcitonin in children with acute pyelonephritis

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 10/2005

Induction therapy with low-dose intravenous cyclophosphamide, oral mizoribine, and steroids for severe lupus nephritis in children

Ambulatory blood pressure monitoring: mean blood pressure and blood pressure load

Symptomatic urinary tract infections following voiding cystourethrography

Altered activity of plasma hemopexin in patients with minimal change disease in relapse

Glomerulonephritis associated with acute pneumococcal pneumonia: a case report

Clear peritoneal effluent in a child on CCPD with a phlegmonous appendicitis