Assessment the Effect of Dexamethasone on Urinary Cytokines and Renal Scar in Children with Acute Pyelonephritis

One of the most serious complications of acute febrile pyelonephritis in children is the development of renal scar. This study aimed to investigate the effect of dexamethasone on urinary cytokine levels and renal scar in children with acute pyelonephritis. Methods. In a double-blind randomized clinical trial, 60 children aged 3 months to 12 years with acute febrile pyelonephritis enrolled. The experimental group was treated with a combination of antibiotic and dexamethasone, and the control group underwent treatment with antibiotic and placebo. The urinary levels of interleukin -6 (UIL-6) and -8 (UIL-8) were measured before treatment as baseline and were repeated four days later. Results. 52 cases (23 patients with mean age of 34.19 ± 30.82 months in the dexamethasone group, and 29 patients with mean age of 50.55 ± 44.41 months in the control group) completed the study. In the control group, the UIL-6 and UIL-8 level became significantly lower after four days treatment (P < .05). In the dexamethasone group, there was a statistically significant difference between both UIL-6 and UIL-8 levels before and after treatment (P < .05). In patients who had scar on DMSA scan, the mean UIL-8 and UIL-6 levels were significantly high before and after treatment. Conclusion. Results of this study showed that dexamethasone plus antibiotic have no clear superiority to antibiotic therapy alone in decreasing inflammatory cytokines and scar formation. We found out that patients with scar had sustained high levels of biomarkers before and after treatment.