Renal Tubular Damage After Renal Stone Treatment

Trinchieri, Alberto; Mandressi, A.; Zanetti, G.; Ruoppolo, M; Tombolini, P; Pisani, E.

doi:10.1016/s0022-5347(17)40830-5

Cited by 5 publications

(10 citation statements)

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“…serum CK [9][10][11], urine angioten sin-converting enzyme [ 12] and urine (5-galactosidase [ 12] increased significantly with ESWL for urolithiasis. Trinchicri et al [9], Kishimoto et al [ 10] and Parr et al [ 11 ] demonstrated a significant elevation of serum CK level by ESWL suggesting skeletal muscle injury, but no mention was made of urine CK concentrations. Trinchieri et al [9] demonstrated that a significant increase in serum LDH and NAG might be due to blood cell damage in cutaneous and renal circulation.…”

Section: Discussionmentioning

confidence: 95%

“…It is reported that serum and urine lactic dehydroge nase (LDH) [8][9][10], serum and urine N-acetylglucosaminidase (NAG) [8][9][10]. serum CK [9][10][11], urine angioten sin-converting enzyme [ 12] and urine (5-galactosidase [ 12] increased significantly with ESWL for urolithiasis.…”

Section: Discussionmentioning

confidence: 99%

“…Trinchicri et al [9], Kishimoto et al [ 10] and Parr et al [ 11 ] demonstrated a significant elevation of serum CK level by ESWL suggesting skeletal muscle injury, but no mention was made of urine CK concentrations. Trinchieri et al [9] demonstrated that a significant increase in serum LDH and NAG might be due to blood cell damage in cutaneous and renal circulation. Thus, LDH, CK, and NAG might be derived from tissues other than kidney.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Extracorporeal Shockwave Lithotripsy for Urolithiasis on Concentrations of Creatine Kinase Isozymes in Patient Serum and Urine

et al. 1992

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To determine whether extracorporeal Shockwave lithotripsy (ESWL) for urolithiasis causes renal injury, we immunoassayed creatine kinase isozymes (CK-B and CK-M) in serum and urine from patients with renal stone (n = 21) and ureteral stone (n = 18) before and after (0, 2, and 24 h) ESWL. CK-B is generally present in renal tissue at relatively high concentrations, whereas CK-M is found at low concentrations. CK-B and CK-M levels were enhanced both in the serum and urine samples after ESWL in both groups of patients but CK-B levels return to almost normal very rapidly. Because CK-M, which is mainly localized in muscle tissue, also increased in both groups, the increased CK-B in serum after ESWL might be derived not only from kidney but also from muscle tissues which also contain a significant level of CK-B. These results suggest that significant tissue injury, including kidney and muscles, might be caused by ESWL treatment for urolithiasis but there is no long-term renal adverse effect, and that creatine kinase isozymes in serum and urine might be useful markers of tissue injury by such treatment.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of Extracorporeal Shockwave Lithotripsy for Urolithiasis on Concentrations of Creatine Kinase Isozymes in Patient Serum and Urine

et al. 1992

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“…Aside from these side effects, ultramicroscopic changes in glomerules and tubules could occur. 5 Biochemical evidence of renal injury is apparent immediately after ESWL. Blood and urine markers such as renin, creatinine, N-acetyl-β-Ð-glucosaminidase (NAG), galactosidase (BGAL), β-2-microglobulin (B2M), and proteinuria return to near-normal levels within a few days.…”

Section: Discussionmentioning

confidence: 99%

“…N-acetyl-β-Ð-glucosaminidase (NAG) was localized in the cortical tubular cellular lysosomes and the excretion of NAG was increased when the necrosis of the tubular cells, especially of the proximal tubules that occurred (5). Excretion decreased by day 7, although it was still statistically higher than the pretreatment level.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Process of Recycling and Renal Parenchymal Injury after ESWL with Metabolites Excreted in the Urine

et al. 2013

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Objectives: To show renal parenchymal injury depending on extracorporeal shock wave lithotripsy (ESWL). Methods: The patients with one renal stone and in whom ESWL is planned among the patients in whom renal stone was determined. Their 24-h urine samples were collected just before and after the ESWL treatment. Cit (citrate), UrA (uric acid), RBP (retinol-binding protein), NAG (N-acetyl-β-Ð-glucosaminidase), Cr (creatinine), Na (sodium), K (potassium), P (phosphor), Ca (calcium), and Cl (chlorine) metabolites excreted in urine were evaluated after urine samples were taken on the study day. Changes in the metabolites excreted; the number, frequency, and duration of ESWL shock wave; the energy; and the body mass index were recorded. The results for p < 0.05 will be accepted as statistically significant. Results: Two sessions of ESWL were applied to a total of 20 patients. When metabolites excreted in the urine before (B1E) and after (A1E) the first session of ESWL, and before (B2E) and after (A2E) the second session of ESWL, were evaluated, no statistically significant result for Ca and Cl excretion was noted. For NAG and Cr, a significant difference was observed in terms of metabolite excretion between B1E and B2E. For other metabolites, we saw that there is no difference between B1E and B2E. While a significant metabolite change was observed for RBP, NAG, Cr, and Na as long as A1E and A2E ESWL session number increases, other metabolites were not significant. Conclusion: Shock waves induce significant damage to the renal and adjacent tissues as indicated by a significant increase in cell-escaped enzymes and electrolytes and the extent of damage depends on the energy and the number of shock wave exposure.

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