Are endourological procedures for nephrolithiasis treatment associated with renal injury? A review of potential mechanisms and novel diagnostic indexes

Mykoniatis, Ioannis; Sarafidis, Pantelis; Memmos, D.; Anastasiadis, Anastasios; Dimitriadis, Georgios; Hatzichristou, Dimitrios

doi:10.1093/ckj/sfaa020

Cited by 11 publications

(10 citation statements)

References 75 publications

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“…Как правило, большинство проведенных малоинвазивных эндоурологических вмешательств завершается успешно, и пациенты покидают лечебное учреждение в самые ранние сроки при отсутствии контроля за функцией почек. Если в первые дни после вмешательства функция почек все-таки подвергается оценке, то рутинно используемые маркеры, такие как мочевина и Cr сыворотки крови, не отражают степень повреждения почки и не позволяют судить о долгосрочных последствиях [1].…”

Section: липокалин связанный с нейтрофильной желатиназой (Neutrophil ...unclassified

“…На смену традиционным хирургическим вмешательствам пришли эндоурологические процедуры, несомненными преимуществами которых являются низкая частота послеоперационных осложнений, высокая эффективность и сокращение сроков пребывания в стационаре. Однако нельзя не согласиться с мнением I. Mykoniatis и соавт., что исследования последних лет в большей степени были сосредоточены на сравнительном анализе эффективности малоинвазивных методов в достижении состояния, свободного от камней («stone free»), в то время как влияние этих методов на функцию почки изучено недостаточно [1]. В зависимости от метода лечения повреждение почечной паренхимы может быть:…”

Section: Introductionunclassified

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New biomarkers of kidney damage and their use in minimally invasive treatment of urolithiasis.

Белый¹,

Клочков²,

Klochkov³

2023

ECU

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Introduction. The effect of various minimally invasive treatment for kidney stones on renal function has not been sufficiently studied. To assess the specificity, severity, and prognostic significance of renal injury of urolithiasis and its minimally invasive treatment, it is necessary to search for «biomarkers of injury». The concentration of serum urea and creatinine used in routine clinical practice, the glomerular filtration rate change in the later stages of the disease and are functional parameters. Materials and methods. The data were searched in the PubMed, Web of Science, Google Scholar, еLibrary.ru using the following keywords: «acute kidney injury», «KIM-1», «kidney injury molecule 1», «NGAL», «neutrophil gelatinase- associated lipocalin», «L-FABP», «liver-type fatty acid binding protein», «cystatin C», «retrograde intrarenal surgery», «percutaneous nephrolithotomy», «kidney injury urolithiasis», «kidney injury nephrolithiasis». Results. Today new biomarkers have been proposed to detect renal injury at the initial stages. These are neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, kidney injury molecule-1 (KIM-1) and liver-type fatty acid binding protein (L-FABP). The level of NGAL and KIM-1 increases until the serum creatinine level increases and the corresponding histological changes in the renal parenchyma develop. In percutaneous nephrolithotomy, multiple punctures and postoperative bleeding are independent risk factors for deterioration of renal function in the long term, and the large size and high density of stones, staghorn stones, and long duration of intervention are largely associated with the development of acute renal injury in the early postoperative period. Obstructive uropathy affects kidney damage in the postoperative period. The elimination of obstruction leads to a decrease in KIM-1 in urine already in the early postoperative period. The dynamics of biomarker levels suggests that percutaneous nephrolithotomy causes more renal injury than retrograde intrarenal surgery (RIRS). Conclusion. Аny minimally invasive treatment for kidney stones may lead to renal injury, which is not always accompanied by impaired function. The mechanisms of renal injury in various variants of minimally invasive treatment for kidney stones have specific features, and the short-term and long-term consequences are currently not fully determined. Further research evaluating the effect of various minimally invasive methods of urolithiasis treatment on the condition of the renal tubules using modern biomarkers is needed.

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Section: липокалин связанный с нейтрофильной желатиназой (Neutrophil ...unclassified

Section: Introductionunclassified

New biomarkers of kidney damage and their use in minimally invasive treatment of urolithiasis.

Белый¹,

Клочков²,

Klochkov³

2023

ECU

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“…RIRS has gained acceptance as the first treatment alternative for renal stones sized up to 20 mm and in other specified circumstances [ 1 ]. RIRS studies investigated the surgical outcomes for overall population have verified the impact of certain surgical and medical complications [ 2 ] or renal injury [ 3 ]. Although RIRS is widely accepted as minimally invasive treatment, its complications and possible renal damage must be dealt with.…”

Section: Introductionmentioning

confidence: 99%

A warning system for urolithiasis via retrograde intrarenal surgery using machine learning: an experimental study

Jeong

Chang

Lee³

et al. 2022

BMC Urol

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Background To develop a warning system that can prevent or minimize laser exposure resulting in kidney and ureter damage during retrograde intrarenal surgery (RIRS) for urolithiasis. Our study builds on the hypothesis that shock waves of different degrees are delivered to the hand of the surgeon depending on whether the laser hits the stone or tissue. Methods A surgical environment was simulated for RIRS by filling the body of a raw whole chicken with water and stones from the human body. We developed an acceleration measurement system that recorded the power signal data for a number of hours, yielding distinguishable characteristics among three different states (idle state, stones, and tissue–laser interface) by conducting fast Fourier transform (FFT) analysis. A discrete wavelet transform (DWT) was used for feature extraction, and a random forest classification algorithm was applied to classify the current state of the laser-tissue interface. Results The result of the FFT showed that the magnitude spectrum is different within the frequency range of < 2500 Hz, indicating that the different states are distinguishable. Each recorded signal was cut in only 0.5-s increments and transformed using the DWT. The transformed data were entered into a random forest classifier to train the model. The test result was only measured with the dataset that was isolated from the training dataset. The maximum average test accuracy was > 95%. The procedure was repeated with random signal dummy data, resulting in an average accuracy of 33.33% and proving that the proposed method caused no bias. Conclusions Our monitoring system receives the shockwave signals generated from the RIRS urolithiasis treatment procedure and generates the laser irradiance status by rapidly recognizing (in 0.5 s) the current laser exposure state with high accuracy (95%). We postulate that this can significantly minimize surgeon error during RIRS.

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“…The high level of recurrence is burdened with significant socio-economic consequences [1]. About 50 % of patients have one recurrent episode of nephrolithiasis, and more than 10-15 % of patients report frequent recurrences with the need for second-look surgical treatment [2]. Their probability is 11 %, 20 %, 31 % and 39 % after 2, 5, 10 and 15 years, respectively [3].…”

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The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

Postol

Sahalevych²,

Serhiichuk³

et al. 2022

ZMJ

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Urolithiasis is one of the most common urological conditions (30–45 %), peaking in the 4th–6th decades of life. About 50 % of patients have one recurrent episode of nephrolithiasis during their lifetime, and among the operated patients, more than 10–15 % of individuals report recurrences with the need for repeated surgical treatment. Increasing the incidence of nephrolithiasis in the world requires the development of new and improvement of existing methods of surgical treatment, which would be characterized by a high level of efficiency and low invasiveness with minimal complications and postoperative rehabilitation. The use of a combination of percutaneous nephrolithotripsy and flexible ureteronephrolithotripsy, especially in complex cases of urolithiasis, can increase the safety and improve the treatment of nephrolithiasis by combining the positive qualities of both methods. Aim. To summarize the data of the world scientific literature on the treatment of nephrolithiasis by studying a combination of percutaneous nephrolithotripsy and retrograde or antegrade flexible intrarenal surgery based on the evaluation of their effectiveness and safety. Materials and methods. The literature review was conducted using the databases PubMed, Google Scholar, Web of Science and Scopus for the period 2015–2022. The following keywords were used for the search: surgical treatment of nephrolithiasis, endoscopic combined intrarenal surgery (ECIRS), percutaneous nephrolithotomy, retrograde intrarenal surgery, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotomy, simultaneous use of flexible ureterorenoscopy and percutaneous nephrolithotripsy. Conclusions. The use of ECIRS increases the effectiveness of one-stage treatment of nephrolithiasis with minimal complications and reduces the number of re-operations required. Treatment of complex forms of nephrolithiasis may be a priority for ECIRS. The main disadvantages of ECIRS are the need for simultaneous operation of two operating surgeons and the availability of two sets of endoscopic equipment, which make this procedure expensive.

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Are endourological procedures for nephrolithiasis treatment associated with renal injury? A review of potential mechanisms and novel diagnostic indexes

Cited by 11 publications

References 75 publications

New biomarkers of kidney damage and their use in minimally invasive treatment of urolithiasis.

New biomarkers of kidney damage and their use in minimally invasive treatment of urolithiasis.

A warning system for urolithiasis via retrograde intrarenal surgery using machine learning: an experimental study

The use of endoscopic combined intrarenal surgery in the treatment of nephrolithiasis

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