Tarigopula Vivek, Devana Sudheer Kumar, Sharma Aditya Prakash, Zohmangaihi Deepy
Department of Urology and Renal Transplant, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Urology, Postgraduate Institute of Medical Sciences, Chandigarh, India.
Indian J Urol. 2025 Jul-Sep;41(3):210-215. doi: 10.4103/iju.iju_53_25. Epub 2025 Jul 1.
Prior studies showed that oxidative stress (OS) is increased in patients with urolithiasis. Urinary 8-hydroxy 2-deoxyguanosine (8-OHdG) is a well-established marker of OS, and its levels are elevated in patients with urolithiasis. It is unknown whether this increased OS persists even after stone removal. We aimed to evaluate the change in urinary 8-OHdG levels in patients with urolithiasis following complete stone clearance.
A prospective pre-post study was conducted at a single center (Institute Ethics Committee approval: NK/5965/MS/029). Patients with urolithiasis undergoing surgery for stone clearance were included. Patients with known comorbidities, malignancy, systemic illnesses, body mass index >30 kg/m, age >50 years, serum creatinine >1.5 mg/dl, and incomplete clearance were excluded. Twenty-four-hour urinary 8-OHdG levels were measured using the Enzyme-Linked Immunosorbent Assay method preoperatively and 3 months post-surgery.
Forty patients (24 males) with a mean age of 34.65 (±11.02) years were analyzed. Thirty-seven patients had renal stones, while 3 had proximal ureteral stones (median stone size = 20 mm). Percutaneous nephrolithotripsy was performed in 33 patients, while 7 underwent various other surgical procedures for stone removal. There was no significant difference in urinary 8-OHdG levels following stone clearance; preoperative 25.770 (1.47-60.38)-μg/g-creatinine versus postoperative value of 32.00 (6.57-117.35)-μg/g-creatinine; = 0.63. No significant correlation was found between age, gender, smoking or alcohol consumption, degree of hydronephrosis or stone burden, and urinary 8-OHdG levels.
The baseline OS in urolithiasis patients does not change after complete stone clearance. Whether this persistent OS is responsible for stone recurrence needs to be explored.
先前的研究表明，尿路结石患者的氧化应激（OS）水平升高。尿8-羟基-2-脱氧鸟苷（8-OHdG）是一种公认的氧化应激标志物，尿路结石患者的该标志物水平会升高。目前尚不清楚即使在结石清除后这种升高的氧化应激是否仍然存在。我们旨在评估尿路结石患者在结石完全清除后尿8-OHdG水平的变化。
在单一中心进行了一项前瞻性前后对照研究（机构伦理委员会批准号：NK/5965/MS/029）。纳入接受结石清除手术的尿路结石患者。排除已知患有合并症、恶性肿瘤、全身性疾病、体重指数>30kg/m²、年龄>50岁、血清肌酐>1.5mg/dl以及结石清除不完全的患者。术前及术后3个月采用酶联免疫吸附测定法测量24小时尿8-OHdG水平。
分析了40例患者（24例男性），平均年龄为34.65（±11.02）岁。37例患者患有肾结石，3例患有近端输尿管结石（结石中位大小 = 20mm）。33例患者接受了经皮肾镜碎石术，7例接受了其他各种结石清除手术。结石清除后尿8-OHdG水平无显著差异；术前为25.770（1.47 - 60.38）μg/g肌酐，术后为32.00（6.57 - 117.35）μg/g肌酐；P = 0.63。年龄、性别、吸烟或饮酒、肾积水程度或结石负荷与尿8-OHdG水平之间未发现显著相关性。
尿路结石患者的基线氧化应激在结石完全清除后未发生变化。这种持续的氧化应激是否导致结石复发有待进一步探讨。
