Enzymatic Evaluation of Renal Damage Caused by Different Therapeutic Procedures for Kidney Stone Disease

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 1995 Jan 1

PMID 8725030

Citations 1

Authors

G Sakkas

T Becopoulos

A Karayannis

G Drossos

K Giannopoulou

Affiliations

Soon will be listed here.

Abstract

In an attempt to evaluate renal injury relative to open surgery, percutaneous nephrolithotripsy (PCN) and extracorporeal shock wave lithotripsy (ESWL) were studied in 52 patients with renal calculus disease. Preoperative and postoperative urinary levels of N-acetyl-glycosaminidase (NAG), a sensitive marker of renal tubular damage, were studied. No significant changes were noted in posttreatment urinary NAG values among patients who underwent ESWL or PCN. Although statistically nonsignificant, a constant mild increase of urinary NAG was observed after PCN, that has to be evaluated with long-term follow-up studies. The shock wave number or power in cases treated with ESWL as well as the number of renal punctures in the PCN group did not change the effect on renal tubular function. Diabetics and patients with chronic renal disease treated by ESWL did not show any significant change in posttreatment urinary NAG levels. In contrast to that, all patients treated by open surgery had significant, intense and prolonged increase of the postoperative NAG values, especially those treated by ischaemic nephrolithotomy. Comparing the three different therapeutic modalities, open surgical procedures had the most significant effect on renal function and this difference was statistically significant. We therefore suggest that ESWL does not endanger renal function, while open surgery must be reserved for selected cases.

Citing Articles

Surgical management of pediatric urolithiasis.

Mishra S, Ganpule A, Manohar T, Desai M Indian J Urol. 2009; 23(4):428-34.

PMID: 19718300 PMC: 2721576. DOI: 10.4103/0970-1591.36718.

References

Price R, DANCE N, Richards B, Cattell W . The excretion of N-acetyl-beta-glucosaminidase and beta-galactosidase following surgery to the kidney. Clin Chim Acta. 1970; 27(1):65-72. DOI: 10.1016/0009-8981(70)90375-x. View

Ruiz Marcellan F, Ibarz Servio L . Evaluation of renal damage in extracorporeal lithotripsy by shock waves. Eur Urol. 1986; 12(2):73-5. DOI: 10.1159/000472585. View

Howards S, Merrill E, Harris S, Cohn J . Ultrasonic lithotripsy: laboratory evaluation. Invest Urol. 1974; 11(4):273-7. View

Jung K, Schulze B, Sydow K . Diagnostic significance of different urinary enzymes in patients suffering from chronic renal diseases. Clin Chim Acta. 1987; 168(3):287-95. DOI: 10.1016/0009-8981(87)90004-0. View

Wilson W, Preminger G . Extracorporeal shock wave lithotripsy. An update. Urol Clin North Am. 1990; 17(1):231-42. View

Fitzpatrick J, Sleight M, Braack A, Marberger M, WICKHAM J . Intrarenal access: effects on renal function and morphology. Br J Urol. 1980; 52(6):409-14. DOI: 10.1111/j.1464-410x.1980.tb03078.x. View

Trinchieri A, Mandressi A, Zanetti G, Ruoppolo M, Tombolini P, Pisani E . Renal tubular damage after renal stone treatment. Urol Res. 1988; 16(2):101-4. DOI: 10.1007/BF00261965. View

Delius M . This month in Investigative Urology: effect of extracorporeal shock waves on the kidney. J Urol. 1988; 140(2):390. DOI: 10.1016/s0022-5347(17)41641-7. View

Marberger M, Eisenberger F . Regional hypothermia of the kidney: surface or transarterial perfusion cooling? A functional study. J Urol. 1980; 124(2):179-83. DOI: 10.1016/s0022-5347(17)55363-x. View

10.

Boyce W, Elkins I . Reconstructive renal surgery following anatrophic nephrolithotomy: followup of 100 consecutive cases. J Urol. 1974; 111(3):307-12. DOI: 10.1016/s0022-5347(17)59954-1. View

11.

Mayo M, Krieger J, Rudd T . Effect of percutaneous nephrostolithotomy on renal function. J Urol. 1985; 133(2):167-9. DOI: 10.1016/s0022-5347(17)48867-7. View

12.

Guder W, Ross B . Enzyme distribution along the nephron. Kidney Int. 1984; 26(2):101-11. DOI: 10.1038/ki.1984.143. View

13.

Tataranni G, Farinelli R, Zavagli G, Logallo G, Farinelli A . Tubule recovery after obstructive nephropathy relief: the value of enzymuria and microproteinuria. J Urol. 1987; 138(1):24-7. DOI: 10.1016/s0022-5347(17)42975-2. View

14.

Webb D, Fitzpatrick J . Percutaneous nephrolithotripsy: a functional and morphological study. J Urol. 1985; 134(3):587-91. DOI: 10.1016/s0022-5347(17)47306-x. View

15.

WICKHAM J, Hanley H, JOEKES A . Regional renal hypothermia. Br J Urol. 1967; 39(6):727-43. DOI: 10.1111/j.1464-410x.1967.tb09856.x. View

16.

Kaude J, Williams C, Millner M, Scott K, Finlayson B . Renal morphology and function immediately after extracorporeal shock-wave lithotripsy. AJR Am J Roentgenol. 1985; 145(2):305-13. DOI: 10.2214/ajr.145.2.305. View

17.

Whiting P, ROSS I, Borthwick L . Serum and urine N-acetyl-beta-D-glucosaminidase in diabetics on diagnosis and subsequent treatment, and stable insulin dependent diabetics. Clin Chim Acta. 1979; 92(3):459-63. DOI: 10.1016/0009-8981(79)90227-4. View

18.

Gonick H, Kramer H, Schapiro A . Urinary -glucuronidase activity in renal disease. Arch Intern Med. 1973; 132(1):63-9. View

19.

Assimos D, Boyce W, Furr E, Espeland M, Holmes R, Harrison L . Selective elevation of urinary enzyme levels after extracorporeal shock wave lithotripsy. J Urol. 1989; 142(3):687-90. DOI: 10.1016/s0022-5347(17)38853-5. View

20.

Damiani E, Cattaneo M, Sessa C, Zucca E, Cavalli F, Bertolini A . Enzymuria in carboplatin nephrotoxicity. Tumori. 1987; 73(5):487-91. DOI: 10.1177/030089168707300510. View