Articles producció científica> Medicina i Cirurgia

Role of dexamethasone in controlling the proinflammatory cytokine cascade in the first episode of paediatric acute pyelonephritis

  • Identification data

    Identifier: imarina:9332030
    Authors:
    Rius-Gordillo, NFerré, NGonzález, JDIbars, ZParada-Ricart, EEscribano, J
    Abstract:
    Febrile urinary tract infection is a common bacterial infection in childhood. The kidney damage after acute pyelonephritis (APN) could be related to the stimulation of the proinflammatory response. We aimed to investigate the role of inflammatory cytokines and the effect of dexamethasone after a first episode of APN.Subanalysis of the DEXCAR RCT in which children with confirmed APN (1 month-14 years) were randomly assigned to receive a 3 days course of either intravenous dexamethasone or placebo. Urinary cytokine levels at diagnosis and after 72 h of treatment were measured.Ninety-two patients were recruited. Younger patients, males and those with abnormalities in the ultrasound study or vesicoureteral reflux showed higher values of urinary cytokines. Patients with severe APN had higher Tumour Necrosis Factor (TNF)α levels (81.0 ± 75.8 vs. 33.6 ± 48.5 pg/mg creatinine, p = 0.015). Both intervention groups showed similar basal clinical characteristics, including urinary cytokine levels. Treatment reduced urinary cytokine levels irrespective of dexamethasone administration. Neither the intervention group nor the urinary cytokine levels modulated the development of kidney scars.Basal urinary cytokines were associated with age, abnormal ultrasound and vesicoureteral reflux. Patients with severe APN had higher TNFa urinary levels. Administration of dexamethasone in children with APN does not improve the control of the proinflammatory cytokine cascade.© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.
  • Others:

    Author, as appears in the article.: Rius-Gordillo, N; Ferré, N; González, JD; Ibars, Z; Parada-Ricart, E; Escribano, J
    Department: Medicina i Cirurgia
    URV's Author/s: Escribano Subías, Joaquín / Ferre Pallas, Natalia / Parada Ricart, Esther / Rius Gordillo, Neus
    Keywords: Urinary-tract-infections Kidney scarring Cytokines Corticosteroids Acute pyelonephritis vesicoureteral reflux serum risk renal scar kim-1 kidney scarring interleukin-8 cytokines corticosteroids children biomarkers
    Abstract: Febrile urinary tract infection is a common bacterial infection in childhood. The kidney damage after acute pyelonephritis (APN) could be related to the stimulation of the proinflammatory response. We aimed to investigate the role of inflammatory cytokines and the effect of dexamethasone after a first episode of APN.Subanalysis of the DEXCAR RCT in which children with confirmed APN (1 month-14 years) were randomly assigned to receive a 3 days course of either intravenous dexamethasone or placebo. Urinary cytokine levels at diagnosis and after 72 h of treatment were measured.Ninety-two patients were recruited. Younger patients, males and those with abnormalities in the ultrasound study or vesicoureteral reflux showed higher values of urinary cytokines. Patients with severe APN had higher Tumour Necrosis Factor (TNF)α levels (81.0 ± 75.8 vs. 33.6 ± 48.5 pg/mg creatinine, p = 0.015). Both intervention groups showed similar basal clinical characteristics, including urinary cytokine levels. Treatment reduced urinary cytokine levels irrespective of dexamethasone administration. Neither the intervention group nor the urinary cytokine levels modulated the development of kidney scars.Basal urinary cytokines were associated with age, abnormal ultrasound and vesicoureteral reflux. Patients with severe APN had higher TNFa urinary levels. Administration of dexamethasone in children with APN does not improve the control of the proinflammatory cytokine cascade.© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.
    Thematic Areas: Serviço social Saúde coletiva Psicología Pediatrics, perinatology and child health Pediatrics Odontología Nutrição Medicine (miscellaneous) Medicina iii Medicina ii Medicina i Interdisciplinar General medicine Farmacia Enfermagem Educação física Ciências biológicas iii Ciências biológicas ii Ciências biológicas i Ciência de alimentos Biotecnología
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: neus.rius@urv.cat esther.parada@urv.cat neus.rius@urv.cat natalia.ferre@urv.cat joaquin.escribano@urv.cat
    Author identifier: 0000-0002-2838-1525 0000-0002-5041-459X
    Record's date: 2024-08-03
    Papper version: info:eu-repo/semantics/publishedVersion
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Acta Paediatrica. 113 (3): 564-572
    APA: Rius-Gordillo, N; Ferré, N; González, JD; Ibars, Z; Parada-Ricart, E; Escribano, J (2024). Role of dexamethasone in controlling the proinflammatory cytokine cascade in the first episode of paediatric acute pyelonephritis. Acta Paediatrica, 113(3), 564-572. DOI: 10.1111/apa.17034
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2024
    Publication Type: Journal Publications
  • Keywords:

    Medicine (Miscellaneous),Pediatrics,Pediatrics, Perinatology and Child Health
    Urinary-tract-infections
    Kidney scarring
    Cytokines
    Corticosteroids
    Acute pyelonephritis
    vesicoureteral reflux
    serum
    risk
    renal scar
    kim-1
    kidney scarring
    interleukin-8
    cytokines
    corticosteroids
    children
    biomarkers
    Serviço social
    Saúde coletiva
    Psicología
    Pediatrics, perinatology and child health
    Pediatrics
    Odontología
    Nutrição
    Medicine (miscellaneous)
    Medicina iii
    Medicina ii
    Medicina i
    Interdisciplinar
    General medicine
    Farmacia
    Enfermagem
    Educação física
    Ciências biológicas iii
    Ciências biológicas ii
    Ciências biológicas i
    Ciência de alimentos
    Biotecnología
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