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Pediatric Nephrology

, Volume 23, Issue 3, pp 429–433 | Cite as

Urinary interleukin-6 is useful in distinguishing between upper and lower urinary tract infections

  • Luis Miguel RodríguezEmail author
  • Belén Robles
  • José Manuel Marugán
  • Ángeles Suárez
  • Fernando Santos
Original Article

Abstract

This study was designed to determine whether the measurement of interleukin (IL)-6 in urine is useful for distinguishing between acute pyelonephritis and lower urinary tract infection. This observational study was carried out at León Hospital (Spain) on 35 patients (ten boys) aged between 0 and 14 years with urinary tract infection. Urinary levels of IL-6 were determined with enzyme-linked immunosorbent assay (ELISA) at diagnosis and after recovery. Renal dimercaptosuccinate acid (DMSA) scan was performed on all patients to discard or confirm acute pyelonephritis. The mean urinary concentration [x ± standard deviation (SD)] of IL-6 at diagnosis was 20.3 ± 23.3 and 5.3 ± 9.7 pg/ml in patients with acute pyelonephritis and lower urinary infection, respectively [95% confidence interval (CI): 2.6–27.4; p < 0.01]. Specificity for a value of IL-6 >15 pg/ml, was 94.1% (95% CI: 91.1–97.1). Positive predictive value for IL-6 >15 pg/ml was 87.5% (95% CI: 81.1–93.8). IL-6 was undetectable in the urine of both groups of patients at the time of recovery. Urinary levels of IL-6 are useful in differentiating between upper and lower urinary tract infection in children. In this clinical setting, a value >15 pg/ml is a strong indicator of acute pyelonephritis.

Keywords

Urinary tract infection Acute pyelonephritis Interleukin-6 Sensitivity Specificity Likelihood ratio 

Notes

Acknowledgments

This work was supported by grant FIS 97/1125 from Carlos III Institute, Spanish Ministry of Health. This work was partially presented at the 13th Congress of the International Paediatric Nephrology Association, Adelaide, Australia, 2004.

Conflict of interest statement

None of the authors have any commercial or other association that might pose a conflict of interest.

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Copyright information

© IPNA 2007

Authors and Affiliations

  • Luis Miguel Rodríguez
    • 1
    • 3
    Email author
  • Belén Robles
    • 1
  • José Manuel Marugán
    • 1
  • Ángeles Suárez
    • 1
  • Fernando Santos
    • 2
  1. 1.Department of PaediatricsLeón HospitalLeónSpain
  2. 2.Department of Pediatrics, Hospital Central de Asturias and School of MedicineUniversity of OviedoOviedoSpain
  3. 3.Servicio de PediatríaHospital de LeónLeónSpain

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