以尿液生化指標分析體外震波碎石對腎臟之影響
沈志宇1、劉展榮1、黃鶴翔1
1成功大學醫學院附設醫院泌尿部
Evaluation of the Impact of Shock Wave Lithotripsy on Kidneys Using Neutrophil Gelatinase-associated Lipocalin, Kidney Injury Molecule-1, and 3-Nitrotyrosine
Chih Yu Shen1, Chan Jung Liu1, Ho Shiang Huang1, Ph.D
1Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
Objectives: To investigate the impact of extracorporeal shock wave lithotripsy (ESWL) on renal damage using urine neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1(KIM-1), and 3-Nitrotyrosine (3-NT) levels and to examine the relationship of these biomarkers with patient and calculus characteristics as well as ESWL treatment parameters.
Materials and methods: We prospectively recruited 83 patients with renal and ureter stones requiring ESWL for previously untreated urinary stones and assigned them for ESWL treatment with either the Dornier Compact Delta lithotripter or the Siemens Lithostar multiline lithotripter based on their preference. Blood and urine samples were obtained from each patient on the day they received ESWL and one week after. Urine NGAL, KIM-1 and 3-NT concentrations were measured using commercial kits.
Results: There were no statistically significantly differences in the levels of urine NGAL and 3-NT before or after ESWL between the two lithotripters. The mean urine levels of KIM-1 decreased significantly one week after ESWL in the Siemens group (1.33 ± 1.52 to 0.81 ± 0.79 ng/ml, p=0.027 ) and in all patients (n=83) (1.48 ± 2.07 to 0.82 ± 0.80, p=0.014).
Conclusion: Renal stones treated using ESWL may provide a beneficial effect against renal inflammation as suggested by the significantly decreased post-ESWL urine KIM-l levels among all the enrolled patients. The results of this study showed that the urine KIM-1 levels significantly decreased after ESWL, which indicated that the procedure is likely to reduce renal inflammation caused by urolithiasis.