title: Urinary expression of novel tissue markers of kidney injury after ureteroscopy, shockwave lithotripsy, and in normal healthy controls.
abstract: OBJECTIVE
  Shockwave lithotripsy (SWL) and ureteroscopy (URS) are minimally invasive treatment alternatives for kidney stones. Although less invasive, SWL subjects the renal parenchyma to a high level of energy and the potential to cause renal injury. The ability to detect renal injury post-SWL in a reliable and noninvasive way would be clinically beneficial. Kidney injury molecule 1 (KIM-1) and N-acetyl-β-D-glucosaminidase (NAG) are two proteins secreted by the kidney into the urine and have been found to be sensitive markers of acute kidney injury in transplant patients. The aim of this work was to measure urinary levels of KIM-1 and NAG in patients with kidney stone who were treated by SWL or URS and in nonstone volunteers.
  
  
  METHODS
  Patients with kidney stones who were treated by SWL (n = 50) or URS (n = 10) were recruited. Voided urine samples were collected before and 2 to 3 hours after URS and SWL. In addition, further urinary specimens were collected 2 days and 2 weeks post-SWL treatment. Voided urine samples from healthy volunteers were also collected.
  
  
  RESULTS
  Mean KIM-1 values were increased in patients with kidney stones when compared with volunteers. KIM-1 and NAG levels significantly increased post-SWL and returned to baseline within 2 weeks post-SWL. Poor kidney function was significantly associated with increased biomarker activity both in baseline and post-SWL measurements. There was no significant change in urinary KIM-1 and NAG concentrations before and after URS.
  
  
  CONCLUSIONS
  Kim-1 and NAG levels significantly increased post-SWL treatment suggesting a potential role for these urinary markers in identifying patients at higher risk of tissue injury.
authors.affiliation: 1 Division of Urology, Department of Surgery, Western University , London, Ontario, Canada .
authors.forename: Nader
authors.initials: N
authors.lastname: Fahmy
authors.forename: Alp
authors.initials: A
authors.lastname: Sener
authors.forename: Venkata
authors.initials: V
authors.lastname: Sabbisetti
authors.forename: Linda
authors.initials: L
authors.lastname: Nott
authors.forename: R Michael
authors.initials: RM
authors.lastname: Lang
authors.forename: Blayne K
authors.initials: BK
authors.lastname: Welk
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Méndez-Probst
authors.forename: Roderick A
authors.initials: RA
authors.lastname: MacPhee
authors.forename: Susan
authors.initials: S
authors.lastname: VanEerdewijk
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cadieux
authors.forename: Joseph V
authors.initials: JV
authors.lastname: Bonventre
authors.forename: Hassan
authors.initials: H
authors.lastname: Razvi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D000072596:Hepatitis A Virus Cellular Receptor 1; D006801:Humans; D007668:Kidney / Q000293:injuries*; D007669:Kidney Calculi / Q000628:therapy / Q000652:urine*; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008562:Membrane Glycoproteins / Q000652:urine*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000652:urine*; D053040:Nephrolithiasis; D011991:Receptors, Virus; D018666:Ureteroscopy / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D015415:Biomarkers; C491143:HAVCR1 protein, human; D000072596:Hepatitis A Virus Cellular Receptor 1; D008562:Membrane Glycoproteins; C117339:NBAS protein, human; D009363:Neoplasm Proteins; D011991:Receptors, Virus