Benli Erdal, Ayyildiz Sema Nur, Cirrik Selma, Noyan Tevfik, Ayyildiz Ali, Cirakoglu Abdullah
Department of Urology, Faculty of Medicine, Ordu University, Ordu, Turkey.
Department of Biochemistry, Faculty of Medicine, Ordu University, Ordu, Turkey.
Int Braz J Urol. 2017 Sep-Oct;43(5):887-895. doi: 10.1590/S1677-5538.IBJU.2016.0638.
URS is a very commonly used procedure for treatment of ureter stones. Increased hydrostatic pressure in the collecting system linked to fluids used during the procedure may cause harmful effects on the kidney. The aim of this study is to determine whether the URS procedure has a negative effect on the kidney by investigating NGAL, KIM-1, FABP and Cys C levels in urine.
This study included 30 patients undergoing ureterorenoscopy (URS) for ureter stones. Urine samples were collected 5 times; before the URS procedure (control) and at 1, 3, 5 and 12 hours following the procedure. NGAL, KIM-1, FBAP and Cys C levels were measured in urine and compared with the control values.
The NGAL levels in urine before the procedure and at 1, 3, 5 and 12 hours after the procedure were 34.59±35.34; 62.72±142.32; 47.15±104.48; 45.23±163.16 and 44.99±60.79ng/mL, respectively (p=0.001). Similarly, the urinary KIM-1, FABP and Cys C levels were found to increase compared to control values; however this increase did not reach statistical significance (p >0.05).
After the URS procedure, there were important changes in NGAL, FABP, KIM-1 and Cys C levels. These changes reached statistical significance for NGAL, but did not reach significance for the other parameters. In conclusion, the URS procedure significantly affects the kidney; however, this effect disappears over time.
输尿管镜碎石术(URS)是治疗输尿管结石非常常用的一种手术。该手术过程中使用的液体导致集合系统内静水压升高,可能会对肾脏产生有害影响。本研究的目的是通过检测尿液中中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子-1(KIM-1)、脂肪酸结合蛋白(FABP)和胱抑素C(Cys C)水平,来确定URS手术是否会对肾脏产生负面影响。
本研究纳入了30例因输尿管结石接受输尿管镜检查(URS)的患者。收集5次尿液样本,分别在URS手术前(对照)以及术后1、3、5和12小时。检测尿液中NGAL、KIM-1、FBAP和Cys C水平,并与对照值进行比较。
术前及术后1、3、5和12小时尿液中NGAL水平分别为34.59±35.34;62.72±142.32;47.15±104.48;45.23±163.16和44.99±60.79ng/mL(p=0.001)。同样,与对照值相比,尿KIM-1、FABP和Cys C水平也有所升高;然而,这种升高未达到统计学显著性(p>0.05)。
URS手术后,NGAL、FABP、KIM-1和Cys C水平发生了重要变化。这些变化中NGAL达到了统计学显著性,但其他参数未达到显著性。总之,URS手术对肾脏有显著影响;然而,这种影响会随时间消失。