Do Serum C-reactive Protein and Interleukin-6 Predict Kidney Scarring After Urinary Tract Infection?

• Published in: Indian journal of pediatrics 2013-12, Vol.80 (12), p.1002-1006
• Main Authors: Rodríguez, Luis Miguel, Robles, Belén, Marugán, José Manuel, Suárez, Ángeles, García Ruiz de Morales, José María
• Format: Article
• Language: English
• Subjects: Bacterial diseases; Bacterial diseases of the urinary system; Biological and medical sciences; C-Reactive Protein - analysis; Child; Child, Preschool; Cicatrix - pathology; Female; General aspects; Gynecology; Human bacterial diseases; Humans; Infant; Infectious diseases; Interleukin-6 - blood; Kidney - pathology; Male; Medical sciences; Medicine; Medicine & Public Health; Nephrology. Urinary tract diseases; Original Article; Pediatrics; Sensitivity and Specificity; Urinary system involvement in other diseases. Miscellaneous; Urinary Tract Infections - pathology; Urinary tract. Prostate gland
• ISSN: 0019-5456; 0973-7693
• DOI: 10.1007/s12098-013-1045-4

Objective To investigate if serum C-reactive protein (s-CRP) and interleukin 6 (s-IL6) provide information for predicting renal damage and for DMSA patient selection in children with urinary tract infection (UTI). Methods This observational study was carried out in children with UTI. s-CRP and s-IL6 were measured at UTI diagnosis. Patients forming renal scarring were identified by DMSA scans. The usefulness of s-CRP and s-IL6 measurements for nephropathy scarring diagnosis was evaluated using diagnostic quality and efficiency indexes. Results Thirty-two children were included in the study. Eight showed renal scarring after the follow-up. The s-CRP was 110.23 ± 59.69 mg/L and 52.46 ± 63.13 mg/L for patients with and without renal scarring. The s-IL6 concentration was 18.34 ± 11.80 pg/mL and 8.07 ± 9.51 pg/mL respectively. The cut-off points for optimum nephropathy scarring diagnosis were 115 mg/L for s-CRP and 20 pg/mL for s-IL6. The value of highest sensitivity for s-CRP was >5 mg/L (S:100 %) and greatest specificity was >150 mg/L (Sp:95.83). The highest sensitivity for s-IL6 was >4 pg/mL (S:100 %) and the maximum specificity was >40 pg/mL (Sp:100 %). Conclusions Results confirm that children who will develop renal scarring show higher levels of s-IL6 and s-CRP at UTI diagnosis. However, none of the techniques provide sufficient information for predicting renal damage in all patients and for DMSA patient selection