当前位置: X-MOL 学术bioRxiv. Biochem. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Ureterorenoscopic (URS) lithotripsy and balloon dilation cause acute kidney injury and distal renal tubule damage
bioRxiv - Biochemistry Pub Date : 2021-01-12 , DOI: 10.1101/2021.01.12.426334
Ho-Shiang Huang , Chan-Jung Liu

Ureterorenoscopy (URS) is believed to be a safe and effective procedure to treat ureteral stone or ureteral stricture. Rapidly increased intrarenal pressure during URS may have a negative impact on the kidney, but the effect on renal functions is not well known. The aim of this study is to evaluate whether URS balloon dilation or lithotripsy would cause acute kidney injury (AKI), which was evaluated by urine neutrophil gelatinase associated lipocalin (NGAL) and renal tubular damage, which was evaluated by urine ? glutathione S-transferase (GST) and ?GST. This prospective study consisted of 207 patients with mean age 53.8 years old between September 2012 and June 2013. Four groups were included: the ureteral stricture group (group 1), the ureteral stone group (group 2), and two control groups. URS induced increased uNGAL on both Days 1 and 14 in both groups, and only elevated u-?GST levels were noted on Day 14 after URSL. On Day 14, the difference between low-grade and high-grade hydronephrosis was significant in group 1 (p < 0.001) rather than group 2 (p = 0.150). By multivariate logistic regression analysis, age, baseline eGFR, and stone size > 1.0 cm were associated with complete recovery of hydronephrosis after URS on Day 14. Ureteral stone patients with preserved renal function suffered more AKI (uNGAL) than those with impaired renal function. However, URS-related AKI had no significant difference between stone ≤ 1 cm and > 1 cm subgroups. Besides, urine ?GST and ?GST were both significantly higher in stone > 1 cm subgroup when compared to ≤ 1 cm subgroup. In conclusion, URS laser lithotripsy and balloon dilatation all resulted in AKI and renal tubular damage on Day 14 though post-URS double-J (DBJ) stenting was performed in every patient.

中文翻译:

输尿管镜(URS)碎石术和球囊扩张引起急性肾损伤和远端肾小管损伤

输尿管镜检查(URS)被认为是治疗输尿管结石或输尿管狭窄的安全有效方法。在URS期间迅速升高的肾内压力可能会对肾脏产生负面影响,但对肾功能的影响尚不清楚。这项研究的目的是评估URS球囊扩张或碎石术是否会引起急性肾损伤(AKI)(由尿中性粒细胞明胶酶相关脂质钙蛋白(NGAL)评估)和肾小管损伤(由尿液评估)?谷胱甘肽S-转移酶(GST)和?GST。这项前瞻性研究由2012年9月至2013年6月之间的207位平均年龄为53.8岁的患者组成。包括四组:输尿管狭窄组(第1组),输尿管结石组(第2组)和两个对照组。两组均在第1天和第14天URS诱导uNGAL升高,而在URSL后第14天仅观察到u-βGST水平升高。在第14天,第1组(p <0.001)而不是第2组(p = 0.150)的轻度和高度肾积水之间的差异显着。通过多因素logistic回归分析,年龄,基线eGFR和结石大小> 1.0 cm与URS术后第14天肾积水完全恢复有关。保留肾功能的输尿管结石患者的AKI(uNGAL)比肾功能受损的患者多。但是,与URS相关的AKI在≤1 cm的亚组和> 1 cm的亚组之间无显着差异。此外,结石> 1 cm亚组的尿βGST和γGST均显着高于≤1 cm亚组。结论,
更新日期:2021-01-13
down
wechat
bug