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

TNF-α is one of the most potent cytokines in proinflammatory reactions. This article contributes to evaluate the correlation between urinary TNF-α and inflammatory response markers in children with acute pyelonephritis. 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-α and creatinine. We also evaluated our patients with routine biochemical studies. One hundred and twenty children with acute pyelonephritis were evaluated. Urinary TNF-α/Cr was 0.0051 ± 0.00083 Pg/g creatinine. The authors found out a significant difference in urinary TNF-α/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). We concluded that urinary TNF-α/Cr might be a good indicator for inflammatory response in children with acute pyelonephritis.