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

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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.

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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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Authors and Affiliations

  1. Department of Paediatrics, León Hospital, León, Spain

    Luis Miguel Rodríguez, Belén Robles, José Manuel Marugán & Ángeles Suárez

  2. Department of Pediatrics, Hospital Central de Asturias and School of Medicine, University of Oviedo, Oviedo, Asturias, Spain

    Fernando Santos

  3. Servicio de Pediatría, Hospital de León, Altos de Nava s/n, 24008, León, Spain

    Luis Miguel Rodríguez

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  1. Luis Miguel Rodríguez
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  2. Belén Robles
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  3. José Manuel Marugán
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  4. Ángeles Suárez
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  5. Fernando Santos
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Correspondence to Luis Miguel Rodríguez.

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Rodríguez, L.M., Robles, B., Marugán, J.M. et al. Urinary interleukin-6 is useful in distinguishing between upper and lower urinary tract infections. Pediatr Nephrol 23, 429–433 (2008). https://doi.org/10.1007/s00467-007-0670-4

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  • DOI: https://doi.org/10.1007/s00467-007-0670-4

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