Urinary Tumor Necrosis Factor-Alpha a Good Indicator for Inflammatory Response in Pyelonephritis

Background: TNF-? is one of the most potent cytokines in proinflammatory reactions. Objectives: This article contributes to evaluate the correlation between urinary TNF-? and inflammatory response markers in children with acute pyelonephritis. Patients and Methods: This cross sectional study, was performed on children with acute pyelonephritis. Fresh random urine samples were obtained before treatment of pyelonephritis. Urine samples were tested for TNF-? and creatinine. We also evaluated our patients with routine biochemical studies. Results: One hundred and twenty children with acute pyelonephritis were evaluated. Urinary TNF-?/Cr was 0.0051 0.00083 Pg/g creatinine. The authors found out a significant difference in urinary TNF-?/Cr between patients who have normal and abnormal levels of urine leukocytes, urine protein, urine culture, erythrocyte sedimentation rate and C- reactive protein. This study revealed a significant correlation between urinary TNF-alpha and urine WBC (r = 0.36, P value = 0.02), ESR (r = 0.75, P value = 0.03) and CRP (r = 0.58, P value = 0.02). Conclusions: We concluded that urinary TNF-?/Cr might be a good indicator for inflammatory response in children with acute pyelonephritis.