Evaluating ESWL-induced renal injury based on urinary TNF-α, IL-1α, and IL-6 levels

Göktaş, Cemal; Coşkun, Abdurrahman; Bicik, Zerrin; Horuz, Rahim; Ünsal, İbrahim; Serteser, Mustafa; Albayrak, Selami; Sarıca, Kemal

doi:10.1007/s00240-012-0467-1

Cited by 16 publications

(19 citation statements)

References 12 publications

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“…SWL treatment may induce inflammation and increase the fragility of the ureter at the location of the stone. Goktas et al showed that urine inflammatory cytokines increased after SWL treatment (11). Thus, unsuccessful SWL treatment seems to increase the risk of avulsion.…”

Section: Discussionmentioning

confidence: 99%

The management of total avulsion of the ureter from both ends: Our experience and literature review

Sevinc¹,

Balaban²,

Özkaptan³

et al. 2016

Arch Ital Urol Androl

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Objective: To evaluate the treatment modalities of total ureteral avulsion and to clarify the risk factors of this serious complication. Methods: This study retrospectively analyzed the data of 3 patients with complete ureteral avulsion during ureteroscopy. Of the three patients, two had distal ureteral complete avulsion, and one total ureteral avulsion on both ends. Ureteroneocystostomy (UNC) was immediately performed after distal ureteral avulsion cases. Ileal ureter substition was performed on the same session after the total ureteral avulsion in both ends. Two of the patients were under chronic use of corticosteroid treatment due to diagnosis of idiopathic trombocytopenic purpura and myastenia gravis and all patients had unsuccesful shockwave litotripsy (SWL) treatment history with at least 1 month period before surgery. Results: The patient who had ileal ureter substitution was followed at 3-month intervals by ultrasonography and renal function tests and she was uneventful after a 2 year follow-up period. The patients treated with UNC were followed up at 3 month interval by ultrasonography and renal function tests. They had normal renal function 1 year after the operation Conclusion: Complete ureteral avulsion is a rare but severe complication. Treatment modality can vary and ileal ureter can be applied succesfully in the total ureter avulsion in both ends when bladder capacity is not enough for a Boari flap. Failed SWL and/or corticosteroid treatment history of patients seems to increase the risk of the ureteral avulsion.KEY WORDS: Avulsion; Lithotripsy; Ureterorenoscopy. quency of complications varies between 0.5% and 10% in the literature (1-3). Ureteral avulsion is the most serious complication and occurs in 0-0.5% patients (4). Treating ureteral avulsion is a challenge. Patient comorbidities, the condition of the kidney, severity of the ureteral damage, and experience of the surgeon can affect the choice of treatment. In this study, we aimed to discuss our experience and possible leading factors of this serious complication in the light of the current literature. MATERIALS AND METHODSWe retrospectively analyzed three ureteral avulsion cases and treatment modalities at two referral hospitals between January 2008 and October 2014. All patients underwent rigid ureteroscopic procedures for removing ureteral stones, and ureteral avulsion occurred during the retrograde examination of the ureter. Of the three patients (1 man, 2 women; age: 28-65 years, one right, two left), the avulsed ureter was repaired during the same session of the ureterorenoscopic surgery. The ureter stones were located in the distal ureter in two patients and in the proximal ureter in one patient. All patients had unsuccessful SWL treatment and at least a 2 week interval before further investigation and treatment were applied. Two patients who have been diagnosed with idiopathic thrombocytopenic purpura and myastenia gravis received chronic corticosteroid treatment. The patients were evaluated with abdominal X-ray, ultrasonography, int...

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Section: Discussionmentioning

confidence: 99%

The management of total avulsion of the ureter from both ends: Our experience and literature review

Sevinc¹,

Balaban²,

Özkaptan³

et al. 2016

Arch Ital Urol Androl

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“…They reported a significant increase in the level of IL-6 during early phase (24 hours after ESWL). They also found the same results about levels of IL-1ɑ during a 14-day period (12). Also, Dundar et al revealed a significant increase in the level of IL-1ɑ in the early phase (24 hours after ESWL) and IL-6 over a 14-day course in patients underwent ESWL (22).…”

Section: Discussionmentioning

confidence: 58%

“…These waves can lead to damage to the renal artery directly. It may also cause an inflammatory response, known as ESWL-induced nephritis (12,13). Considering the importance of this issue, we studied many parameters neglected in other studies including sex, size, location and side of stone in urinary tract.…”

Section: Discussionmentioning

confidence: 99%

“…Our conclusion should be interpreted with caution because of small study population. Nevertheless, in several studies, these variables concerning ESWLinduced inflammation have not been fully investigated (12,13); in comparison to those which take these variables into consideration (24,25). The examination of interleukins is limited and it does not have a common worldwide application to evaluate ESWL-induced inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…The exposure of shock waves for the purpose of destructing urinary calculi could have been undesirable effects on the soft tissues and vascular system of urinary tract. Subsequently, it could lead to inflammation and tissue damage (12,13). Several pro-inflammatory markers have been utilized in urological practices in order to gain an accurate and detailed diagnosis of renal damage.…”

Section: Introductionmentioning

confidence: 99%

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Urinary level of interleukin-1alpha and interleukin-6 in patients underwent extracorporeal shock wave lithotripsy

Chenari¹,

Fazeli²,

Jahantigh³

et al. 2017

J Renal Inj Prev

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Findings of the current study highlighted the underlying inflammatory process following extracorporeal shock wave lithotripsy (ESWL) procedure and can be a good sample for further investigations. Introduction: Extracorporeal shock wave lithotripsy (ESWL) was established as a dramatic procedure in the treatment of urinary stones. According to the growing utilization of ESWL as a major method of urinary stone, management and the reports have been reported based on renal tissue damage. Objectives: We decided to examine the severity of ESWL-induced renal tissue damage and its related factors by monitoring the urinary levels of cytokines. Patients and Methods: In this study, the urinary samples of 32 patients with urolithiasis were taken before, 24 hours and 14 days after ESWL and interleukin-1ɑ (IL-1a) and interleukin-6 (IL-6) levels were measured by enzyme-linked immunosorbent assay (ELISA) method. Results: Our findings indicated that there was a significant difference between the urinary levels of both IL-1ɑ and IL-6 in 14 days before and after ESWL. Conclusion: According to our results, ESWL leads to an inflammatory process in the urinary tract and the inflammation have continuously increased up to 14 days after procedure. Please cite this paper as:

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The Effect of Modified University of Wisconsin Solution on Kidney Preservation Time

Coşkun

Yeğen

Arbak

et al. 2016

European Microscopy Congress 2016: Proceedings

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Protection of organ function is important factor for the success of organ transplantation. Protection activity and also protection time period are dependent on a large scale of pre‐transplant preservation solutions. Therefore, donor organs are being preserved in special preservation solutions such as University of Wisconsin (UW), Histidin‐Triptophan‐Ketogluterate (HTK) and Celcior solution. For that aim, UW is the most preferred solution, even so, this solution could not preserve the organs over 36 hours. In this study, the ingredients of the UW solution were changed to extend the preservation time and also to provide more effective protection. Rat model is used for investigation of time related morphological changes between UW (group I) and Modified UW (Mod UW) (group II) solutions during preservation time. Rat kidneys were perfused with respective solutions. Totally perfused kidneys were removed and placed either in UW or Mod UW solutions and also kept during 2, 10, 24 and 72 h at 4° C. Kidney tissue samples were taken at given time intervals and fixed with 10% formaldehyde, and then these samples were prepared for paraffin sections. These tissue samples were also taken at 72nd hour, they were fixed in 2.5% glutaraldehyde and processed for epoxy resin embedding. For light microscopical evaluation, renal injury, based on tubular and glomerular degeneration, inflammatory cell infiltration, and vasocongestion has been scored with using a scale ranging from 0 to 3 (0: none; 1: mild; 2: moderate; and 3:severe) for each criterion. Liquid samples were also taken 2, 10, 24 and 72 h at 4° C from the storage media and investigated for LDH activity which was measured using standard chemistry method (Siemens ADVIA 1800 chemistry System). Microscopical examinations showed that Mod UW solution provided good preservation for all time intervals than UW solution. These results are consistent with lactate dehydrogenase (LDH) levels. Vacuolated tubular cells, as well as decreased renal tubules and glomerular degeneration described a prominent tissue injury revealed at 72nd h of UW group. Podocyte degeneration, formation of hump with GBM thickening revealed in 72nd h of UW group at transmission electron microscopical level. These degeneration parameters were observed less than in 72nd h of Mod UW group. It was concluded that Mod UW solution at low temperature is very effective and suitable for preservation up to 72 h.

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Evaluating ESWL-induced renal injury based on urinary TNF-α, IL-1α, and IL-6 levels

Cited by 16 publications

References 12 publications

The management of total avulsion of the ureter from both ends: Our experience and literature review

The management of total avulsion of the ureter from both ends: Our experience and literature review

Urinary level of interleukin-1alpha and interleukin-6 in patients underwent extracorporeal shock wave lithotripsy

The Effect of Modified University of Wisconsin Solution on Kidney Preservation Time

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