Aydin HR et al, 2015: The Application of Kidney Injury Molecule-1 to Determine the Duration Between Shockwave Lithotripsy Sessions.
Aydin HR, Irkilata L, Aydin M, Daggulli M, Taskin MH, Demirel HC, Adanur S, Moral C, Atilla MK, Sancaktutar AA.
Department of Urology, Recep Tayyip Erdoğan University , Rize, Turkey.
Department of Urology, Samsun Training and Research Hospital , Samsun, Turkey.
Department of Urology, Dicle University , Diyarbakir, Turkey.
Department of Microbiology, Samsun Training and Research Hospital , Samsun, Turkey.
Department of Urology, Ataturk University , Erzurum, Turkey.
PURPOSE: We aimed to evaluate the role of kidney injury molecule-1 (KIM-1) in determining the intervals between shockwave lithotripsy (SWL) sessions.
PATIENTS AND METHODS: This was a prospective, controlled study. It included 40 patients with unilateral kidney stones and 40 healthy persons of a similar age group as controls. The patients' midflow urine samples were collected before SWL and 1 hour, 1 day, 1 week, and 1 month after the procedure.
RESULTS: The average age in the SWL and control groups was 45 ± 14 and 39 ± 15 years, respectively (P = 0.336). The average KIM-1 value before SWL was 0.74 ± 0.35 ng/mL, which was significantly higher than that of the control group (0.51 ± 0.14 ng/mL) (P < 0.001). Similarly, the average values of the urine samples after SWL were higher than those of the control group (P < 0.001). When the KIM-1 values of the patients given SWL were compared within the group, the KIM-1 values 1 hour (1.06 ± 0.51) and 1 day (0.99 ± 0.67) after the procedure were statistically clearly higher than those before the procedure (P < 0.001) and statistically clearly higher than those of the control group (P = 0.005). The KIM-1 values 1 week and 1 month after the procedure were not significantly different than the preprocedure values (P = 0.652 and P = 0.747, respectively).
CONCLUSION: KIM-1 is a noninvasive biomarker that may be used to show renal damage because of stones and early-stage renal damage linked to SWL. In addition, post-SWL KIM-1 values may be used to determine the interval between SWL sessions.
J Endourol. 2015 Sep 25. [Epub ahead of print]
It would be interesting to know which of the many post-ESWL parameters measured so far is really signalizing the right time gap between two ESWL sessions. The references do not show that studies including two sessions have been done to determine the right time interval. So all we have got so far seems to be hypothesized.