title: The effect of shock wave lithotripsy on nitric oxide and malondialdehyde levels in plasma and urine samples.
abstract: Shock wave lithotripsy (SWL) is accepted as the first treatment choice for most urinary stones, but it has adverse effects on the kidneys. The mechanisms underlying shock wave-induced renal injury have been discussed and include shear stress, thermal and cavitation effects and free radical formation. We investigated the effects of SWL on plasma and urinary nitrite, a stable metabolite of nitric oxide (NO), and malondialdehyde (MDA) concentrations. Between February and October 2004, 12 men and 8 women with renal calculi were treated using a Dornier MPL-9000 lithotriptor. The ages ranged from 22 to 45 years (average age: 33.7 years). Plasma and urinary NO and MDA levels were analysed before, immediately after, 30 and 60 min and 24 h after SWL. Plasma NO levels were higher than baseline levels immediately, and at 30, 60 min and 24 h after treatment (p = 0.016, p = 0.031, p = 0.033 and p = 0.045, respectively). Simultaneously, the mean urinary NO levels also showed significant elevation after SWL compared with baseline values, except for 24 h (p = 0.021, p = 0.023 and p = 0.048, respectively). The mean levels of plasma MDA showed statistically significant elevation immediately, and 30 and 60 min after SWL termination compared with pre-SWL values (p = 0.012, p = 0.008 and p = 0.012, respectively). Urinary MDA levels obtained immediately (p = 0.035), and 30 (p = 0.006) and 60 (p = 0.045) min after SWL were increased compared to pre-SWL values. We speculate that SWL treatment causes oxidative stress caused by renal ischemia-reperfusion (I/R) injury. Additionally, the increase of NO production may have prevented renal damage caused by vasoconstriction.
authors.affiliation: Department of Biochemistry, School of Medicine, Atatürk University, Erzurum, Turkey. aksoyhulya@yahoo.com
authors.forename: Hülya
authors.initials: H
authors.lastname: Aksoy
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Aksoy
authors.forename: Hamdullah
authors.initials: H
authors.lastname: Turhan
authors.forename: Sait
authors.initials: S
authors.lastname: Keleş
authors.forename: Tevfik
authors.initials: T
authors.lastname: Ziypak
authors.forename: Isa
authors.initials: I
authors.lastname: Ozbey
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008315:Malondialdehyde / Q000097:blood* / Q000652:urine*; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood* / Q000652:urine*
chemical_list: D009569:Nitric Oxide; D008315:Malondialdehyde