Antioxidant therapy is associated with a reduction in the serum levels of mediators of renal injury following lithotripsy for renal calculi.
OBJECTIVE
To investigate the effects of antioxidant therapy on the levels of mediators of shock wave induced renal injury in patients with renal calculi treated with extracorporeal shock wave lithotripsy (ESWL).


METHODS
One hundred and twenty patients with renal calculi were divided into three treatment groups: Group A patients (n = 39) served as a control group; Group B patients (n = 41) were given 2 capsules of Nature Made((R)) antioxidants 2 hours before, and 2 and 8 hours after ESWL and Group C patients (n = 40) were given 2 capsules of the antioxidants at 2 and 8 hours after ESWL. Blood and urine samples were obtained from all patients just before the start of treatment with ESWL, and at 2 and 24 hours and on day 7 and 28 after ESWL. Levels of mediators of renal injury such as serum alkaline phosphatase (ALP), C-reactive protein (CRP) and lactate dehydrogenase (LDH) were measured. Urinary levels of albumin and ALP were also determined as measures of renal tubular injury.


RESULTS
Patients given antioxidants had significantly reduced mean serum concentration of ALP (p < 0.001) at 24 hours, lower serum ALP and LDH on day 7 and 28, and lowest CRP on day 28 after ESWL. They also had higher urine albumin (p < 0.001) and ALP (p < 0.001) levels (from 24 hours to day 28) compared with patients who were not given antioxidants.


CONCLUSIONS
These findings suggest that oral antioxidant therapy prior to lithotripsy may reduce the severity of long term renal injury caused by the shock waves.
Kehinde
Elijah O
EO
Department of Surgery (Division of Urology), Faculty of Medicine, Kuwait University, Safat, Kuwait. ekehinde@hsc.edu.kw
Al-Awadi
Khaleel A
KA
Al-Hunayan
Adel
A
Mojiminiyi
Olusegun A
OA
Memon
Anjum
A
Abdul-Halim
Hamdy
H
Fatinikun
Tunde
T
D000328:Adult; D000419:Albuminuria / Q000150:complications; D000469:Alkaline Phosphatase / Q000097:blood / Q000652:urine; D000975:Antioxidants / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000032:analysis; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007669:Kidney Calculi / Q000097:blood* / Q000150:complications / Q000628:therapy*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male
D000975:Antioxidants; D002097:C-Reactive Protein; D003404:Creatinine; D007770:L-Lactate Dehydrogenase; D000469:Alkaline Phosphatase