Shock wave lithotripsy, for the treatment of kidney stones, results in changes to routine blood tests and novel biomarkers: a prospective clinical pilot-study

Abstract

Background: The number of patients undergoing shock wave lithotripsy (SWL) for kidney stones is increasing annually, and as such the development of post-operative complications, such as haematuria and acute kidney injury (AKI) following SWL, is likely to increase. The aim of the study was to evaluate changes in routine blood and novel biomarkers following SWL, for the treatment of kidney stones. Methods: Twelve patients undergoing SWL for solitary unilateral kidney stones were recruited. From patients (8 males and 4 females) aged between 31 and 72 years (median 43 years), venous blood samples were collected preoperatively (baseline), at 30, 120 and 240 min post-operatively. Routine blood tests were performed using a Sysmex XE-5000, and Beckman Coulter AU5800 and AU680 analysers. NGAL, IL-18, IL-6, TNF-α, IL-10 and IL-8 concentrations were determined using commercially available ELISA kits. Results: Significant (p ≤ 0.05) changes were observed in several blood parameters following SWL. NGAL concentration significantly increased, with values peaking at 30 min post-treatment (p = 0.033). Although IL-18 concentration increased, these changes were not significant (p = 0.116). IL-6 revealed a statistically significant rise from pre-operative up to 4 h post-operatively (p < 0.001), whilst TNF-α significantly increased, peaking at 30 min post-SWL (p = 0.05). There were no significant changes to IL-10 and IL-8 concentrations post-SWL (p > 0.05). Conclusions: Changes to routine blood tests and specific biomarkers, in the future, may be more useful for clinicians. In turn, identification of a panel of biomarkers could provide valuable data on "normal" physiological response after lithotripsy. Ultimately, studies could be expanded to identify or predict those patients at increased risk of developing post-operative complications, such as acute kidney injury or. These studies, however, need validating involving larger cohorts.

Selective biomarkers for inflammation and infection are associated with post-operative complications following transperineal template prostate biopsy (TTPB): a single-centre observational clinical pilot-study

“…Interestingly, Plasma IL-10 concentrations significantly increased following TTPB. Our data differ from Hughes et al [37], who reported no significant changes to IL-10 concentrations post-operatively following shock wave lithotripsy (SWL), non-invasive urological procedure performed to treat small kidney stones. Normally, IL-10 is considered to have potent anti-inflammatory properties, but increased levels have been reported to be associated with infection.…”

“…The present study found a significant increase in plasma IL-6 concentrations at 120 min and 240 min post-TTPB, which follows a similar pattern of change as reported after transurethral resection of the prostate (TURP) [36] and shock wave lithotripsy for kidney stones [37], suggesting an immune and stress (inflammatory) response to the procedure.…”

“…The present study showed significant increases in plasma TNF-α concentrations following TTPB, with similar observations being reported by Hughes et al . [ 37 ] following SWL for the treatment of kidney stones. In line with reports Patel et al [ 30 ] and Guan et al [ 31 ], this study found that participant 11 had higher plasma TNF-α concentrations post-TTPB compared to the average group who did not develop any complications.…”

Effectiveness of Extracorporeal Shockwave Lithotripsy and Percutaneous Nephrolithotripsy for the Management of Moderate Size Kidney Stone

“…7 Its importance is appreciated that annually in USA about 1 million affected individuals are treated through ESWL. 16 ESWL technique preferred for the treatment of kidney stone that range between 4 mm and 2cm (size). 17 On the other hand, PCNL was established to lessen the morbidity and mortality linked with open kidney procedures, and it is still the primary management for significant kidney stones today.…”

Effect of Instructional Guidelines on Dietary Knowledge and Practices among Mothers of Children with Kidney Stones

“…It is estimated that stone formers have twice as high a risk of chronic renal disease than non-stone formers. Pediatric kidney stone is increasing in incidence and healthcare costs as well as putting an increasing clinical and budgetary strain on the world's healthcare systems (Hughes et al, 2020). As a result, this problem needs necessitated strategies to optimize the treatment of children with kidney stones and to reduce recurrence risk through preventive medical and dietary management.…”