Cytokines in reflux-nephropathy in children

Abstract

In order to reveal the role of pro- and anti-inflammatory cytokines in formation of renal scar in children with chronic pyelonephritis (CP) and vesico-ureteral reflux (VUR) 123 patients with impaired urodynamics aged from 3 to 14 years were examined at the beginning of the study and after 6 months follow-up. In all of them the 24 hours urine excretion of interleukins 8, 10 (IL-8, 10) and tumor necrosis factor-α (TNF-α) has been measured by immunoenzime method. All the children underwent color Doppler ultrasound (CDUS) examination of kidneys. Three groups of patients were determined: 1) with VUR and normal X-ray and ultrasound pictures of kidneys (n = 94); 2) with CDUS detected reflux nephropathy (RN) (n = 12); 3) with IVU confirmed reflux nephropathy (n = 17). Patients with CP without VUR (n = 10) were used as a control. As a result, all the patients demonstrated significantly elevated daily urine excretion of IL-8, IL-10 and TNF-α in comparison with control (p < 0,05) at first investigation and mild increasing of IL-8 and TNF-α concentration after 6 months of follow-up. In children without X-ray and ultrasound signs of renal scarring IL-10 urine concentration increased approximately in 1,2 times. In opposite, representatives of 2 and 3 groups showed identical cutback of IL-10 level in 24 hours urine within 6 months after first investigation. To conclude, the similar dynamics of IL-10 urine level in patients with X-ray confirmed RN and CDUS sings of renal scar formation suggests that IL-10 can be used as an early marker of renal tissue damage. The diminishing of anti-inflammatory cytokine may reflect the protraction of covered inflammation in renal parenchyma in remission of CP.