Biomarkers for febrile urinary tract infection in children

Role of dexamethasone in controlling the proinflammatory cytokine cascade in the first episode of paediatric acute pyelonephritis

“…Accordingly, the role of different biomarkers in the study and prognosis of patients with urinary tract infection has been investigated in both serum and urine samples. [11][12][13][14][15][16][17][18][19][20][21]34 In our study, we evaluated the urinary concentrations of different biomarkers in 92 paediatric patients with DMSA-confirmed APN.…”

“…Control of this inflammatory cascade could reduce the risk of scarring after an episode of APN, thus reducing the subsequent risk of long‐term complications. Accordingly, the role of different biomarkers in the study and prognosis of patients with urinary tract infection has been investigated in both serum and urine samples 11–21,34 . In our study, we evaluated the urinary concentrations of different biomarkers in 92 paediatric patients with DMSA‐confirmed APN.…”

“…32 These biomarkers were selected according to previous literature and the technical possibility to be detected altogether in a multiplex analysis. [11][12][13][14][15][16][17][18][19][20] Pearson's chi-squared test was used for the statistical comparison of the categorical data. Correlations between quantitative variables were performed by Pearson or Spearman tests as appropriate.…”

“…Thus, even after adequate antimicrobial management, in some cases, the inflammatory process will lead to kidney scarring due to the robust immune response after the stimulation of proinflammatory cytokines 10 . The analysis of serum and urine cytokines, mainly interleukin (IL) 6 and IL8, and other biomarkers like neutrophil gelatinase‐associated lipocalin‐2 (NGAL/Lipocalin‐2), is emerging in the literature, showing higher levels of these proteins in children and adults with UTI and kidney damage 11–20 . Considering this hypothesis, the role of anti‐inflammatory treatment has been assessed as a potential control of cytokine cascade.…”

“…10 The analysis of serum and urine cytokines, mainly interleukin (IL) 6 and IL8, and other biomarkers like neutrophil gelatinase-associated lipocalin-2 (NGAL/Lipocalin-2), is emerging in the literature, showing higher levels of these proteins in children and adults with UTI and kidney damage. [11][12][13][14][15][16][17][18][19][20] Considering this hypothesis, the role of anti-inflammatory treatment has been assessed as a potential control of cytokine cascade. Sharifian et al 21 demonstrated in 54 children with a first episode of APN that coadjuvant treatment with dexamethasone enhanced the decrease in urinary IL6 and IL8 compared with children who received only the usual antimicrobial treatment.…”