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. 2020 Jun 1;25(1):18.
doi: 10.1186/s40001-020-00417-2.

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

Stephen F Hughes  1   2 , Nathan Jones  3   4 , Samantha J Thomas-Wright  5   6 , Joseph Banwell  5   6 , Alyson J Moyes  5   3   7 , Iqbal Shergill  8   5   9
Affiliations

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

Stephen F Hughes et al. Eur J Med Res. .

Abstract

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 pre-operatively (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.

Keywords: Acute kidney injury (AKI); Biomarkers; Inflammation; Kidney stones; Routine blood tests; Shock wave lithotripsy (SWL).

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The effect of SWL, for the treatment of kidney stones, on NGAL concentration. Data points expressed as median ± IQR. p = 0.033 as determined by Friedman test. The intra-assay CV was 4.8%. Patient samples were diluted 1 in 60 as per manufacturer guides
Fig. 2
Fig. 2
The effect of SWL, for the treatment of kidney stones, on IL-18 concentration. Data points expressed as mean ± standard deviation. p = 0.89 as determined by a repeated measures ANOVA. The intra-assay CV was 5.1%
Fig. 3
Fig. 3
The effect of SWL, for the treatment of kidney stones, on IL-6 concentration. Data points expressed as median ± IQR. p < 0.001 as determined by Friedman test. The intra-assay CV was 8.1%
Fig. 4
Fig. 4
The effect of SWL, for the treatment of kidney stones, on TNF-α concentration. Data points expressed as median ± IQRr. p = 0.05 as determined by Friedman test. The intra-assay CV was 6.5%
Fig. 5
Fig. 5
The effect of SWL, for the treatment of kidney stones, on IL-10 concentration. Data points expressed as median ± IQRr. p = 0.086 as determined by Friedman test. The intra-assay CV was 8.1%
Fig. 6
Fig. 6
The effect of SWL, for the treatment of kidney stones, on IL-8 concentration. Data points expressed as median ± IQRr. p = 0.187 as determined by Friedman test. The intra-assay CV was 5.1%
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