title: Evaluation of inflammatory and renal-injury markers in women treated with antibiotics for acute pyelonephritis caused by Escherichia coli.
abstract: The evolution and the relationship between inflammatory and renal-injury markers in women with acute uncomplicated pyelonephritis under antimicrobial therapy were investigated in a prospective study. Markers were measured before and 6 and 24 h after the intravenous administration of 1 g of ceftriaxone. Before treatment, the median levels of all markers except the serum creatinine levels were high. Twenty-four hours after the onset of antibiotic treatment, the C-reactive protein (CRP) level continued to be high, while the serum interleukin-6 (IL-6) levels and the urine IL-6, IL-8, albumin, and immunoglobulin G (IgG) levels decreased significantly. In contrast, serum creatinine and tumor necrosis factor alpha levels and urine N-acetyl-beta-glucosaminidase, alpha1-microglobulin, and beta2-microglobulin levels did not change over time. There was a significant correlation between IL-6 and IL-8 levels and urine albumin and IgG levels (urine albumin and IgG levels are glomerular and urinary tract-injury markers) as well as between serum CRP levels and the levels of the tubular-injury markers. In women with acute pyelonephritis, appropriate antibiotic treatment rapidly decreases serum IL-6 levels and urine IL-6 and IL-8 levels, which correlate well with urine albumin and IgG levels.
authors.affiliation: Service of Infectious Diseases, Institut Clínic Infeccions i Immunologia, Hospital Clínic Universitari-IDIBAPS, Barcelona, Spain. jhorcaja@clinic.ub.es
authors.forename: Juan P
authors.initials: JP
authors.lastname: Horcajada
authors.forename: María
authors.initials: M
authors.lastname: Velasco
authors.forename: Xavier
authors.initials: X
authors.lastname: Filella
authors.forename: Luisa
authors.initials: L
authors.lastname: Alvarez
authors.forename: Elisa
authors.initials: E
authors.lastname: De Làzzari
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Marín
authors.forename: Blanca
authors.initials: B
authors.lastname: Collvinent
authors.forename: Alex
authors.initials: A
authors.lastname: Smithson
authors.forename: Jose Antonio
authors.initials: JA
authors.lastname: Martínez
authors.forename: Mariana
authors.initials: M
authors.lastname: Noguero
authors.forename: Jordi
authors.initials: J
authors.lastname: Vila
authors.forename: Josep
authors.initials: J
authors.lastname: Mensa
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002097:C-Reactive Protein / Q000032:analysis; D002443:Ceftriaxone / Q000627:therapeutic use; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000652:urine; D018836:Inflammation Mediators / Q000097:blood* / Q000652:urine; D015850:Interleukin-6 / Q000097:blood / Q000652:urine; D016209:Interleukin-8 / Q000652:urine; D007668:Kidney / Q000293:injuries; D008875:Middle Aged; D011446:Prospective Studies; D011704:Pyelonephritis / Q000188:drug therapy* / Q000503:physiopathology*
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D007074:Immunoglobulin G; D018836:Inflammation Mediators; D015850:Interleukin-6; D016209:Interleukin-8; D002443:Ceftriaxone; D002097:C-Reactive Protein