title: Selective elevation of urinary enzyme levels after extracorporeal shock wave lithotripsy.
abstract: Urinary enzyme testing has been used by many investigators to diagnose and monitor various types of renal injury. Three urinary enzymes, N-acetyl-beta-glucosaminidase, beta-galactosidase and gamma-glutamyl transferase were monitored in 17 patients before and after a single, unilateral extracorporeal shock wave lithotripsy treatment. Stones were in the renal pelvis or calices except for 1 treated in situ in the proximal ureter. Urine specimens were collected before extracorporeal shock wave lithotripsy and at 1, 3, 5, 7, 10, 14, 21 and 28 days after treatment. N-acetyl-beta-glucosaminidase and beta-galactosidase levels increased significantly after treatment (p less than 0.05). Gamma-glutamyl transferase levels increased after treatment but this was not statistically significant. All enzyme levels were highest on days 1 and 3 after lithotripsy and returned to baseline by day 28. Factors associated with post-treatment enzyme elevation included female sex, a lower pre-treatment creatinine clearance and stone size greater than 1 cm. These findings indicate that there is a transient selective increase in urinary enzyme excretion after extracorporeal shock wave lithotripsy.
authors.affiliation: Department of Surgery, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
authors.forename: D G
authors.initials: DG
authors.lastname: Assimos
authors.forename: W H
authors.initials: WH
authors.lastname: Boyce
authors.forename: E G
authors.initials: EG
authors.lastname: Furr
authors.forename: M A
authors.initials: MA
authors.lastname: Espeland
authors.forename: R P
authors.initials: RP
authors.lastname: Holmes
authors.forename: L H
authors.initials: LH
authors.lastname: Harrison
authors.forename: R L
authors.initials: RL
authors.lastname: Kroovand
authors.forename: D L
authors.initials: DL
authors.lastname: McCullough
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005696:Galactosidases / Q000652:urine*; D006596:Hexosaminidases / Q000652:urine*; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy* / Q000652:urine; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D001616:beta-Galactosidase / Q000652:urine*; D005723:gamma-Glutamyltransferase / Q000652:urine*
chemical_list: D005723:gamma-Glutamyltransferase; D005696:Galactosidases; D006596:Hexosaminidases; D001616:beta-Galactosidase; D000118:Acetylglucosaminidase