Evaluation of Neutrophil Gelatinase–associated Lipocalin, Interleukin-18, and Cystatin C as Molecular Markers Before and After Unilateral Shock Wave Lithotripsy

Kardakos, Ioannis; Volanis, D.; Kalikaki, A.; Tzortzis, Vassilios; Serafetinides, E.; Melekos, Michael D.; Delakas, Dimitrios

doi:10.1016/j.urology.2014.05.034

Cited by 15 publications

(9 citation statements)

References 30 publications

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“…Although there are many variables that can influence NGAL concentration within blood, such as GFR and formation of the biological agent by other cells such as neutrophils, it is important to remember that NGAL is not specific in diagnosing the aetiology of renal impairment, but may apply a crude method of indicating some sort of underlying pathology that needs to be clinically addressed [21,34,35]. It could therefore be appreciated that NGAL could act as an indicator, upon which further investigations, including medical imaging, analysis of a panel of biomarkers are undertaken to reveal the full extent of the complications.…”

Section: Discussionmentioning

confidence: 99%

Shock wave lithotripsy, for the treatment of kidney stones, results in changes to routine blood tests and novel biomarkers: a prospective clinical pilot-study

et al. 2020

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Background: The number of patients undergoing shock wave lithotripsy (SWL) for kidney stones is increasing annually, and as such the development of post-operative complications, such as haematuria and acute kidney injury (AKI) following SWL, is likely to increase. The aim of the study was to evaluate changes in routine blood and novel biomarkers following SWL, for the treatment of kidney stones. Methods: Twelve patients undergoing SWL for solitary unilateral kidney stones were recruited. From patients (8 males and 4 females) aged between 31 and 72 years (median 43 years), venous blood samples were collected preoperatively (baseline), at 30, 120 and 240 min post-operatively. Routine blood tests were performed using a Sysmex XE-5000, and Beckman Coulter AU5800 and AU680 analysers. NGAL, IL-18, IL-6, TNF-α, IL-10 and IL-8 concentrations were determined using commercially available ELISA kits. Results: Significant (p ≤ 0.05) changes were observed in several blood parameters following SWL. NGAL concentration significantly increased, with values peaking at 30 min post-treatment (p = 0.033). Although IL-18 concentration increased, these changes were not significant (p = 0.116). IL-6 revealed a statistically significant rise from pre-operative up to 4 h post-operatively (p < 0.001), whilst TNF-α significantly increased, peaking at 30 min post-SWL (p = 0.05). There were no significant changes to IL-10 and IL-8 concentrations post-SWL (p > 0.05). Conclusions: Changes to routine blood tests and specific biomarkers, in the future, may be more useful for clinicians. In turn, identification of a panel of biomarkers could provide valuable data on "normal" physiological response after lithotripsy. Ultimately, studies could be expanded to identify or predict those patients at increased risk of developing post-operative complications, such as acute kidney injury or. These studies, however, need validating involving larger cohorts.

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Section: Discussionmentioning

confidence: 99%

Shock wave lithotripsy, for the treatment of kidney stones, results in changes to routine blood tests and novel biomarkers: a prospective clinical pilot-study

et al. 2020

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“…NGAL expression is induced in kidney tubular cells during regeneration after kidney injury (29). A previous study (25) has demonstrated that serum and urine levels of NGAL are not different before compared with after 10 days of unilateral shock wave lithotripsy in patients with renal calculi, whereas another study (10) has reported that urinary levels of NGAL increased 24 h after percutaneous nephrolithotripsy for stone removal compared with preoperative levels. To regulate cellular function, NGAL binds to 24p3R (a brain-type organic cation transporter) and megalin multiscavenger membrane receptors (7,21).…”

Section: Discussionmentioning

confidence: 99%

Urinary extracellular vesicle-associated MCP-1 and NGAL derived from specific nephron segments differ between calcium oxalate stone formers and controls

Chirackal

Jayachandran

Wang

et al. 2019

American Journal of Physiology-Renal Physiology

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Randall’s plaque (RP; subepithelial calcification) appears to be an important precursor of kidney stone disease. However, RP cannot be noninvasively detected. The present study investigated candidate biomarkers associated with extracellular vesicles (EVs) in the urine of calcium stone formers (CSFs) with low (<5% papillary surface area) and high (≥5% papillary surface area) percentages of RP and a group of nonstone formers. RPs were quantitated via videotaping and image processing in consecutive CSFs undergoing percutaneous surgery for stone removal. Urinary EVs derived from cells of different nephron segments of CSFs ( n = 64) and nonstone formers ( n = 40) were quantified in biobanked cell-free urine by standardized and validated digital flow cytometer using fluorophore-conjugated antibodies. Overall, the number of EVs carrying surface monocyte chemoattractant protein (MCP)-1 and neutrophil gelatinase-associated lipocalin (NGAL) were significantly lower in CSFs compared with nonstone former controls ( P < 0.05) but did not differ statistically between CSFs with low and high RPs. The number of EVs associated with osteopontin did not differ between any groups. Thus, EVs carrying MCP-1 and NGAL may directly or indirectly contribute to stone pathogenesis as evidenced by the lower of these populations of EVs in stone formers compared with nonstone formers. Validation of EV-associated MCP-1 and NGAL as noninvasive biomarkers of kidney stone pathogenesis in larger populations is warranted.

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“…This wide‐focus‐low‐pressure character may be the reason for decreased renal tubular injury; as detected by uNGAL. Recently, a study by Kardakos et al showed that ESWL did not cause significant rises in uNGAL levels.…”

Section: Discussionmentioning

confidence: 99%

A randomised controlled trial evaluating renal protective effects of selenium with vitamins A, C, E, verapamil, and losartan against extracorporeal shockwave lithotripsy‐induced renal injury

et al. 2016

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Objective To evaluate the protective effects of selenium with vitamins A, C and E (selenium ACE, i.e. antioxidants), verapamil (calcium channel blocker), and losartan (angiotensin receptor blocker) against extracorporeal shockwave lithotripsy (ESWL)‐induced renal injury. Patients and Methods A randomised controlled trial was conducted between August 2012 and February 2015. Inclusion criteria were adult patients with a single renal stone (<2 cm) suitable for ESWL. Patients with diabetes, hypertension, congenital renal anomalies, moderate or marked hydronephrosis, or preoperative albuminuria (>300 mg/L) were excluded. ESWL was performed using the electromagnetic DoLiS lithotripter. Eligible patients were randomised into one of four groups using sealed closed envelopes: Group1, control; Group 2, selenium ACE; Group 3, losartan; and Group 4, verapamil. Albuminuria and urinary neutrophil gelatinase‐associated lipocalin (uNGAL) were estimated after 2–4 h and 1 week after ESWL. The primary outcome was differences between albuminuria and uNGAL. Dynamic contrast‐enhanced magnetic resonance imaging was performed before ESWL, and at 2–4 h and 1 week after ESWL to compare changes in renal perfusion. Results Of 329 patients assessed for eligibility, the final analysis comprised 160 patients (40 in each group). Losartan was the only medication that showed significantly lower levels of albuminuria after 1 week (P < 0.001). For perfusion changes, there was a statistically significant decrease in the renal perfusion in patients with obstructed kidneys in comparison to before ESWL (P = 0.003). These significant changes were present in the control or antioxidant group, whilst in the losartan and verapamil groups renal perfusion was not significantly decreased. Conclusions Losartan was found to protect the kidney against ESWL‐induced renal injury by significantly decreasing post‐ESWL albuminuria. Verapamil and losartan maintained renal perfusion in patients with post‐ESWL renal obstruction.

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Evaluation of Neutrophil Gelatinase–associated Lipocalin, Interleukin-18, and Cystatin C as Molecular Markers Before and After Unilateral Shock Wave Lithotripsy

Cited by 15 publications

References 30 publications

Shock wave lithotripsy, for the treatment of kidney stones, results in changes to routine blood tests and novel biomarkers: a prospective clinical pilot-study

Shock wave lithotripsy, for the treatment of kidney stones, results in changes to routine blood tests and novel biomarkers: a prospective clinical pilot-study

Urinary extracellular vesicle-associated MCP-1 and NGAL derived from specific nephron segments differ between calcium oxalate stone formers and controls

A randomised controlled trial evaluating renal protective effects of selenium with vitamins A, C, E, verapamil, and losartan against extracorporeal shockwave lithotripsy‐induced renal injury

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