Evaluation of Renal Injury in Patients with Renal Stone after ESWL

Kim, Sang Woo; Sul, Cbong Koo

Abstract

The evaluation of renal damage in patients with renal stone after extracorporeal shock wave lithotripsy(ESWL) were analyzed by measuring chemical substances including cell-escaped enzymes in the blood and urine. We measured several chemical substances before ESWL, 1st, 3rd, and 4th day after ESWL. All patients had renal stones which were located in the renal pelvis and renal calices. Glutamic oxalate transaminase(GOT) and glutamic pyruvic transaminase(GPT) reached a peak on the 1st day after ESWL and decreased to pre-ESWL day values by the 4th day. Lactate dehydrogenase(LDH), creatine kinase(CK), and myoglobin also significantly increased on the 1st day after ESWL and decreased but did not return to pretreatment values by the 4th day. Urinary ratio of N-acetyl-beta-d-glucosaminidase(NAG) to creatinine(Cr) increased after ESWL and was still high on the 4th day. These results suggested that hemolysis and myolysis might be developed owing to shock wave exposure, and that the kidney was damagedto some extent. Therefore, we must be taken into account in renal damage during ESWL. Determination of urinary NAG and NAG/Cr ratio may be superior to GOT, GPT, LDH, CK and myoglobin in serum, after shock wave lithotripsy for renal stones.