For treatment of moderate-sized radiolucent renal stones, RIRS and PNL provide significantly higher success and lower retreatment rate compared with SWL. Although PNL is effective, its biggest drawback is its invasiveness. Blood loss, radiation exposure, hospital stay, and morbidities of PNL can be significantly reduced with RIRS technique.

Introduction:The aim of this study was to evaluate lipid peroxidation (LP) and free radical scavenging enzyme activities in kidney tissue of vitamin B 6 -deficient rats. Material and Methods: The rats were divided into control and vitamin B 6 -deficient groups. After 4 weeks of feeding, animals in all groups were anesthetized by thiopental sodium (50 mg/kg). Thoraces were opened, 2 mL blood samples were taken from aortas, then the rats were killed by cervical dislocation, and kidney tissues were removed. Biochemical measurements in kidney tissue were carried out using a spectrophotometer. Results: Total superoxide scavenger activity (TSSA), nonenzymatic superoxide scavenger activity (NSSA), superoxide dismutase (SOD) activities, and antioxidant potential (AOP) values in the vitamin B 6 -deficient group were significantly lower than those of the control group, whereas glutathione peroxidase (GSH-Px), glutathione reductase (GRD), glutathione-S-transferase (GST) activities, and malondialdehyde (MDA) level were significantly higher than those of the control group (p < 0.05). Discussion: The results show that vitamin B 6 deficiency causes an attenuation in antioxidant defense system and an increase in oxidative stress in kidney tissue of rats.

(2015) Renoprotective effect of aliskiren on renal ischemia/reperfusion injury in rats: electron microscopy and molecular study, Renal Failure, 37:2,[343][344][345][346][347][348][349][350][351][352][353][354] Purpose: To determine the protective effect of aliskiren on ischemia-reperfusion (I/R) injury in a rat renal (I/R) model. Methods: Rats were randomly divided into five groups: sham control group; sham control with aliskiren pretreatment; I/R group and I/R with two doses of aliskiren pretreatment. Rats were unilaterally nephrectomized and subjected to 45 min of renal pedicle occlusion followed by 24 h reperfusion. Aliskiren (50 and 100 mg/kg) was administered orally by gavage 24 and 1 h prior to ischemia. After 24 h reperfusion, kidney samples were taken for the determination of malondialdehyde (MDA) level, superoxide dismutase (SOD), glutathione (GSH) activity and histological evaluation. The level of serum creatinine (SCR) and blood urea nitrogen (BUN), renin and angiotensin II (AT-2) was measured in serum samples. Results: Kidneys from I/R groups showed significant increase in MDA level and significant decrease in GSH, and SOD activity. IL-1b, iNOS and NFkB gene expression significantly increased in the I/R groups in the rat kidney tissue. Aliskiren treatment showed a significant down-regulatory effect on IL-1b, iNOS and NFkB mRNA expression. Compared with the sham group, SCR and BUN, renin and AT-2 were significantly increased in the I/R rats, accompanied by histopathological damage to the kidney. Conclusion: Pretreatment with aliskiren ameliorated I/R-induced renal injury through decreasing nitric oxide and AT-2 levels and by the reduction of injury induced by I/R injury and ameliorated renal histopathological molecular and biochemical changes.

For treatment of pregnant women with symptomatic ureteral stones in every location, Holmium laser lithotripsy with a semirigid ureteroscopy can be used as judicious treatment. This approach is effective and safe with an acceptable complication rate.

The objective of the study is to evaluate the effectiveness and safety of miniaturized percutaneous nephrolithotomy (mini-PNL) method in infantile patients <3 years of age diagnosed with renal stones. We studied 48 renal units in 40 patients of infantile patients <3 years of age who underwent mini-PCNL at our institute. The mean age of the patients was 24.02 (5-36) months. The mean diameter of the stones was 22.3 mm (11-45 mm). Intrarenal access was achieved under fluoroscopic (n = 43) or ultrasonographic (n = 5) guidance under general anesthesia. A 20 Fr peel-away sheath, a 17 Fr rigid nephroscope and a pneumatic intracorporeal lithotripsy were used. Mean operative time for PNL was 85 (25-135) min. Mean fluoroscopy time was estimated as 3.7 min. The mean hospital stay was 4.3 days (2-10). Mean hemoglobin loss was 0.89 g/L (11.56-10.67) and three of the patients, including one case during the perioperative period, required blood transfusions. Colonic perforation developed in one case. In two patients, urinary drainage persisted for more than 24 h after withdrawal of the nephrostomy tube. Seven patients developed urinary tract infections (UTI). At the end of the postoperative first week, the stone-free rate was estimated to be 81.2 %. In conclusion, for percutaneous management of renal stones in the infantile age group, mini-PNL is an applicable treatment modality that can be applied through small incisions. It has higher stone-free rates, shorter hospital stays, and excellent esthetic outcomes. In this age group especially, surgical exposure to hypothermia and radiation should be avoided.