SOVREMENNAYA PEDIATRIYA.2018.1(89):80-83; doi 10.15574/SP.2018.89.80

Makieieva N., Morozova O., Makarenko R., Turenko I.
Kharkiv Medical University, Ukraine
Communal Health Protection Institution «Kharkiv City Clinical Children's Hospital No.16», Ukraine
Shapoval Regional Clinical Centre of Urology and Nephrology, Kharkiv, Ukraine
Kharkiv National Medical Academy of Postgraduate Education, Ukraine

Vesicoureteral reflux (VUR) is a retrograde flow of urine from the bladder back into the ureters. One of the leading positions among nephropathy in children is occupied by pyelonephritis, in origin of which congenital anomalies of the urinary tract, including VUR, play the great role. Nephrosclerosis on the background of VUR is formed in 30-60% of patients and leads to the development of the terminal stage of chronic renal insufficiency in 25-60% of patients.
Objective: to determine the clinical relevance of urinary excretion of inflammatory biomarkers (IL-6, IL-8) in children with chronic pyelonephritis and VUR.
Material and methods. In total 54 children with VUR grade III-V after endoscopic correction in the stage of clinical and laboratory remission of pyelonephritis were studied. The IL-6 and IL-8 excretion using «Vektor-Best» test kit (Russia) according to the manufacturer's instruction was determined in the 24-hour collection urine of children applying ELISA test.
Results. In patients with VUR and no evidences of the renal parenchyma scarring, the increased IL-6, IL-8 urinary excretion reflects the latent course of pyelonephritis. Pseudonoralization of the IL-6 and IL-8 urinary excretion in patients with VUD and signs of nephrosclerosis formation appears to be an additional confirmation of the development and progression of the renal parenchyma scarring.
Conclusions. Levels of the urinary excretion of inflammatory biomarkers IL-6 and IL-8 may be used as markers for the inflammatory process and the development of kidney scarring in children with VUD.
Key words: vesicoureteral reflux, children, renal parenchyma scarring, IL-6, IL-8.

References

1. Batyushin MM. (2013). Mechanisms of renal scaring from reflux-nephropathy. Herald Urology. 2: 43–51.

2. Lakomova DYu. (2012). Index of early renal damage in children with vesicoureteral reflux. Saratov Journal of Medical Scientific Research. 8(2): 318–324.

3. Morozov DA, Morrison VV, Morozova OL, Lakomova DY. (2011). Рathogenic basis and modern prospects in early diagnostics of nephrosclerosis in children with vesicoureteral reflux. Saratov Journal of medical scientific Research. 7(1): 151–157.

4. Tokarchuk NI, Odarchuk IV, Zayichko NV. (2015). Аnalysis of education indicators of fibrosis in pyelonephritis on the background of vesicoureteral reflux in children of early age. Sovremennaya pediatriya. 6(70): 93–96. doi 10.15574/SP.2015.70.93.

5. Bitsori M, Karatzi M, Dimitriou H, Christakou E, Savvidou A, Galanakis E. (2011). Urine IL-8 concentrations in infectious and non-infectious urinary tract conditions. Pediatr Nephrol. 26(11): 2003–2007.

6. Basem A. Khalil, Anju Goyal, Alan P Dickson. (2010). Surgical intervention in children with vesicoureteric reflux: are we intervening too late? Pediatric Surgery International. 26(7): 729–731.

7. David A Diamond, Tej K Mattoo. (2012). Endoscopic Treatment of Primary Vesicoureteral Reflux. New England Journal of Medicine. 366(13): 1218–1226. doi 10.1056/NEJMct1108922.

8. Fidan K, Gonen S, Soylemezoglu O. (2013). The association of cytokine gene polymorphism with reflux nephropathy. Journal of pediatric urology. 9(5): 653–658.

9. Gokce I, Alpay H, Biyikli N, Unluguzel G, Dede F, Topuzoglu A. (2010). Urinary levels of interleukin-6 and interleukin-8 in patients with vesicoureteral reflux and renal parenchymal scar. Pediatr Nephrol. 25(5): 905–912. doi 10.1007/s00467-009-1396-2.

10. Lee Hе, Kim D, Kang H. (2015). The diagnosis of febrile urinary tract infection in children may be facilitated by urinary biomarkers. Pediatr.  Nephrol. 30(1): 123–130. doi 10.1007/s00467-014-2905-5.

11. Szmigielska A, Turczyn A, Pańczyk-Tomaszewska M. (2016). Urine interleukin-6, interleukin-8 and transforming growth factor β1 in infants with urinary tract infection and asymptomatic bacteriuria. Cent Eur J Immunol. 41(3): 260–267. doi 10.5114/ceji.2016.63125.

12. Tramma D, Hatzistylianou M, Gerasimou G, Lafazanis V. (2012). Interleukin-6 and interleukin-8 levels in the urine of children with renal scarring. Pediatr Nephrol. 27(9): 1525–1530. doi 10.1007/s00467-012-2156-2.