title: Immediate and long-term high levels of plasma homocysteine after extracorporeal shock wave lithotripsy in patients with renal stone disease.
abstract: BACKGROUND
  Plasma homocysteine levels increase in patients with chronic renal failure. Numerous studies have demonstrated that kidney function is one of the most important determinants of plasma total homocysteine (tHcy) concentration. In this study we aimed to evaluate the relationship between tHcy levels and extracorporeal shock wave lithotripsy (ESWL) for patients with renal stones and to see if the change in homocysteine levels continued if renal dysfunction improved.
  
  
  METHODS
  The study consisted of 20 patients who underwent first-time ESWL for renal stones. Every patient gave 3 blood samples at 24 h before surgery and at 2 days and at 3 months after ESWL for measurement of plasma levels of tHcy, creatinine, vitamin B6, and vitamin B12.
  
  
  RESULTS
  The 20 patients (12 male, 8 female) had a mean age of 42.8 ± 11.7 years. tHcy levels showed a statistically significant increase from 9.4 ± 1.4 to 18 ± 4.8 and 11.2 ± 2.1 at 2 days and at 3 months, respectively. Serum creatinine also showed a statistically significant increase compared to baseline at 2 days and at 3 months after ESWL.
  
  
  CONCLUSIONS
  After first-time ESWL, the increase in serum levels of creatinine and tHcy due to renal injury, such as ischemia/reperfusion injury, may be severe and continue for a long period, such as 3 months. According to baseline levels, the increase in homocysteine levels as an indicator of oxidant stress was more severe than the creatinine levels after ESWL for renal stones. Our patients were first-time ESWL patients; however, in patients who undergo EWSL more than once long-term high tHcy levels should also be considered as renal.
authors.affiliation: Department of Urology, Faculty of Medicine, University of Çukurova, 01330, Adana, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Demir
authors.forename: Volkan
authors.initials: V
authors.lastname: Izol
authors.forename: I Atilla
authors.initials: IA
authors.lastname: Aridogan
authors.forename: Saime
authors.initials: S
authors.lastname: Paydas
authors.forename: Zuhtu
authors.initials: Z
authors.lastname: Tansug
authors.forename: Ugur
authors.initials: U
authors.lastname: Erken
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D007668:Kidney / Q000503:physiopathology; D007669:Kidney Calculi / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D003404:Creatinine