الفهرس 
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Abstract
This study aim is to evaluate the correlation between urinary IL-6 and renal scan in detecting renal scarring in children with obstructive nephropathy.
This case control study was carried out in Ain Shams University Pediatric Hospital, in the period between January 2023 and January 2024. Included thirty (30) pediatric subjects divided into two groups:
• group 1: Patients with obstructive nephropathy n(15): 15 patients diagnosed with obstructive nephropathy and admitted in Pediatric Nephrology Unit Ward, Ain Shams University.
• group 2: Control group n(15): 15 healthy children and adolescents, attending pediatric ER or clinic with negative past and family history of pediatric renal disease (matching with patient group in age and sex).
In the study group, the median age was 6 years, with 73% males and no significant age or sex differences between groups. Among the cases, 46.7% were underweight and 53.3% were stunted. Diagnoses included one-third with posterior urethral valve, bilateral hydronephrosis, and bilateral Vesicoureteral Reflux (VUR), one-third with primary bilateral VUR, and one-third with other conditions like neurogenic bladder and renal stones. Klebsiella was the most common organism found in urine cultures, present in 46.6% of cases.
In our study, urine IL-6 was measured for the cases group during the attack of pyelonephritis and 1 month after resolution of the attack. It was also measured for the control group.
The study found that cases had significantly higher urinary IL-6 levels than controls during acute pyelonephritis (p<0.001) and one month after (p<0.001).
Using the Schwartz formula, the mean eGFR for cases was 86.6 ml/min/1.73m², with CKD grading showing 46.7% in Grade 3, 40% in Grade 1, and 13.3% in Grade 2. No significant correlation was found between urinary IL-6 levels and CKD grades based on eGFR.
The right renal scan most commonly showed grade 0 (53.3%), followed by grade 1 (33.3%), and grades 2 and 3 (6.7% each).In the left renal scan, grade 0 was most common (46.7%), followed by grades 1 and 3 (20% each), and grade 2 (13.3%). Correlating DMSA scan results with CKD grades showed a significant difference in the right renal scan, with Grade 3 CKD having more cases with renal scan Grade 1 and fewer with Grade 0. No significant difference was found in the left renal scan.
In our study, we attempted to correlate IL-6 levels with DMSA scan results in detecting renal scars, but no statistical significance was found. This may be attributed to several factors:
1- Small sample size: Patients were not compliant with undergoing DMSA scans due to concerns about radiation hazards and fear of anesthesia complications.
2- Timing of DMSA scan: Optimal timing for DMSA scan is after acute infection has been treated and resolved, typically 4-6 weeks later, to accurately evaluate the presence and extent of renal scarring (Barola et al., 2024).