evaluation and comparison of urinary cytokines for the diagnosis of acute pyelonephritis

Background: the accurate diagnosis and management of febrile urinary tract infection (uti) is a clinical challenge in the absence of specific clinical and laboratory findings in infants and young children. objectives: the aim of this study was to identify and compare the diagnostic and therapeutic implications of recently introduced cytokines for the diagnosis of acute pyelonephritis (apn). methods: this multicenter prospective study was performed on 37 (female/male = 6.5:1) children with symptomatic culture-proven apn and 37 (female/male = 1.6/1) age-matched febrile children without utis as the control group. urine samples were obtained before antibiotic treatment in both groups and 3 - 4 days after treatment in the uti group, and evaluated for interleukin (il)-1α, il-1β, il-2, il-4, il-6, il-8, il-10, tumor necrosis factor-α (tnfα), monocyte chemoattractant protein-1 (mcp-1), and vascular endothelial growth factor (vegf) using an elisa immunoassay kit. results: mean urinary il-1α, il-4, il-6, and il-8 concentrations significantly increased in the acute phase of apn compared to the control group, and decreased following antibiotic treatment. conclusions: we recommend routine urinalysis and urine culture for the diagnosis of children with apn. urinary il-4 was a rela- tively good cytokine for the prediction and treatment-monitoring of children with acute febrile uti.