Correlation between Urinary IL-6 and Renal Scan Isotope in Detecting Renal Scarring in Children with Obstructive Nephropathy

Abstract Background: Obstructive Nephropathy is any affection of the urinary tract characterized by impairment of urine flow through the tract and which, if left untreated, will cause pro-gressive renal scarring. Interleukin-6 (IL-6) has been extensive-ly studied in children with obstructive nephropathy, focusing on its association with renal scarring. Studies have shown elevated IL-6 levels in children with renal scarring, suggesting its poten-tial as a biomarker for renal inflammation and scarring. Aim of Study: To evaluate the correlation between urinary IL-6 and renal scan in detecting renal scarring in children with obstructive nephropathy. Patients and Methods: This study is an observational ca-secontrol study. This study was conducted at Pediatric Neph-rology Department, Children’s Hospital, Ain Shams University. The study period was 6 months. The study population was 15 admitted cases of proven obstructive nephropathy in an acute attack of pyelonephritis and 15 healthy matched controls.For all enrolled cases, full history was taken including age at diag-nosis, presenting complaint on admission and past history of previous operations. Full clinical examination was conducted, laboratory investigations were done including kidney function tests, urine analysis, IL-6 level in urine and radiological investi-gations including pelvi abdominal ultrasound and DMSA scan. Results: Mean age of the study group was 6 years and 73% were males without any significant statistical difference between the two groups in age or sex. Majority of the cases were diagnosed as posterior urethral valve with bilateral vesi-coureteric reflux and bilateral hydronephrosis, other diagnoses included primary vesicoureteric reflux, neurogenic bladder and ureteric stones.Our study showed that Our study investigated the correlation between urinary IL-6 levels, DMSA renal scans, and chronic kidney disease (CKD) grades in children with ob-structive nephropathy. While we found that there was statisticall significant increase in cases than control groups regarding IL-6 level and that the level significally decreased after resolution of the attack of pyelonephritis (p<0.001), we didn’t observe a significant correlation between IL-6 levels and DMSA renal scan findings. Additionally, there was no significant correlation between IL-6 levels and different grades of CKD. Conclusion: This study found significantly elevated uri-nary IL-6 levels in cases compared to controls during acute pyelonephritis and even after resolution but we didn’t observe a significant correlation between IL-6 levels and DMSA renal scan findings. Our findings suggest that while urinary IL-6 may serve as a marker of renal inflammation, it may not directly cor-relate with the extent of renal scarring or the severity of CKD in pediatric patients with obstructive nephropathy.