TY - JOUR
T1 - Treatment of renal calculi by lithotripsy
T2 - Minimizing short-term shock wave induced renal damage by using antioxidants
AU - Al-Awadi, Khaleel A.
AU - Kehinde, Elijah O.
AU - Loutfi, Issa
AU - Mojiminiyi, Olusegun A.
AU - Al-Hunayan, Adel
AU - Abdul-Halim, Hamdy
AU - Al-Sarraf, Ahmed
AU - Memon, Anjum
AU - Abraham, Mathew P.
N1 - Funding Information:
Acknowledgments This research project was supported by Kuwait Foundation for Advancement of Sciences Research Grant No 2000-07-05. We wish to thank colleagues in Urology Division, Mubarak Hospital for allowing us to study their patients. We will like to thank Mr. Tunde Fatinikun, Mr. K.I Mathew and Technicians in the Departments of Surgery, Obstetrics and Gynaecology, Faculty of Medicine, Kuwait University for their involvement in the analytical aspects of this research project.
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2008/2
Y1 - 2008/2
N2 - Treatment with extracorporeal shock wave lithotripsy (ESWL), the preferred method of treating kidney stones <3 cm in size, has been shown to induce silent and often self-limiting acute and chronic lesions in the kidneys and adjacent organs. We conducted a randomized clinical trial to determine whether ESWL produces ischaemia and reperfusion injury in the kidneys and whether oral administration of antioxidants reduces the degree of short-term renal injury in patients treated with ESWL. The study included 120 patients with renal stones (1-3 cm in size) treated with ESWL. The patients were divided into three groups-patients in group A (n = 39) served as a control group and were not given any antioxidants; patients in group B (n = 41) were given two capsules of antioxidants "Nature Made r" 2 h before ESWL, and 2 and 8 h after ESWL; and patients in group C (n = 40) were given two capsules of the antioxidants 2 and 8 h after ESWL. Double 'J' stents were inserted in patients before treatment with ESWL. Blood and urine samples were obtained from all patients just before the start of treatment with ESWL, and at 2 and 24 h and on 7th and 28th day after ESWL. Serum levels of malondialdehyde (MDA), α-tocopherol, cholesterol, albumin and ascorbic acid, and α-tocopherol/cholesterol ratio were determined. Urinary levels of albumin and β2 microglobulin were also determined as measures of renal tubular injury. At 24 h after ESWL, patients given antioxidants (groups B + C) had significantly reduced mean serum concentration of MDA (P < 0.001); higher levels of serum ascorbic acid (P < 0.001) and serum albumin (P < 0.001); lower α-tocopherol/cholesterol ratio, lower urinary albumin and β2 microglobulin levels compared with patients who did not receive antioxidants (group A). These findings suggest that treatment with ESWL generates free radicals through ischaemic/reperfusion injury mechanism, and that oral administration of antioxidant may protect these patients from short term renal injury caused by ESWL.
AB - Treatment with extracorporeal shock wave lithotripsy (ESWL), the preferred method of treating kidney stones <3 cm in size, has been shown to induce silent and often self-limiting acute and chronic lesions in the kidneys and adjacent organs. We conducted a randomized clinical trial to determine whether ESWL produces ischaemia and reperfusion injury in the kidneys and whether oral administration of antioxidants reduces the degree of short-term renal injury in patients treated with ESWL. The study included 120 patients with renal stones (1-3 cm in size) treated with ESWL. The patients were divided into three groups-patients in group A (n = 39) served as a control group and were not given any antioxidants; patients in group B (n = 41) were given two capsules of antioxidants "Nature Made r" 2 h before ESWL, and 2 and 8 h after ESWL; and patients in group C (n = 40) were given two capsules of the antioxidants 2 and 8 h after ESWL. Double 'J' stents were inserted in patients before treatment with ESWL. Blood and urine samples were obtained from all patients just before the start of treatment with ESWL, and at 2 and 24 h and on 7th and 28th day after ESWL. Serum levels of malondialdehyde (MDA), α-tocopherol, cholesterol, albumin and ascorbic acid, and α-tocopherol/cholesterol ratio were determined. Urinary levels of albumin and β2 microglobulin were also determined as measures of renal tubular injury. At 24 h after ESWL, patients given antioxidants (groups B + C) had significantly reduced mean serum concentration of MDA (P < 0.001); higher levels of serum ascorbic acid (P < 0.001) and serum albumin (P < 0.001); lower α-tocopherol/cholesterol ratio, lower urinary albumin and β2 microglobulin levels compared with patients who did not receive antioxidants (group A). These findings suggest that treatment with ESWL generates free radicals through ischaemic/reperfusion injury mechanism, and that oral administration of antioxidant may protect these patients from short term renal injury caused by ESWL.
KW - Antioxidants
KW - Humans
KW - Renal calculi
KW - Renal injury
KW - Shock waves
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U2 - 10.1007/s00240-007-0126-0
DO - 10.1007/s00240-007-0126-0
M3 - Article
C2 - 18064446
AN - SCOPUS:39049132965
VL - 36
SP - 51
EP - 60
JO - Urolithiasis
JF - Urolithiasis
SN - 2194-7228
IS - 1
ER -