title: Assessment of tissue damage due to percutaneous nephrolithotomy using serum concentrations of inflammatory mediators.
abstract: OBJECTIVE
  To determine the percutaneous nephrolithotomy (PCNL) effects on the tissues using the quantification of inflammatory mediators, and to assess their impact on the development of postoperative complications.
  
  
  METHODS
  Prospective observational non-randomized study on 40 patients underwent to PCNL. 50 patients with kidney stone who were treated by extracorporeal shock wave lithotripsy (ESWL) were used as control group. Interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) were determined at baseline (T0: before treatment), and at 2, 6 and 24hours after (T1, T2 and T3).
  
  
  RESULTS
  No relevant changes on IL-1β and TNF-α were found. IL-6 showed two peaks at 2 and 6hours post-PCNL (median 17.8 and 15.8 pg/mL, respectively). At 24hours CRP had reached its peak value (3.4mg/L). The group treated with ESWL no showed significant changes in any of the markers. The serum concentration of IL-6 and CRP at 24hours post-NLP is different depending on the occurrence of complications (P=.001 and P=.039, respectively). IL-6 showed a good predictive power for the development of complications (AUC .801).
  
  
  CONCLUSIONS
  Tissue damage caused by the PCNL is low. This damage increases significantly in those cases showing postoperative complications. IL-6 at 24hours has been shown to be a good predictive tool for the development of complications.
authors: Servicio de Urología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España. Electronic address: danielfentes@gmail.com.
authors: D
authors: D
authors: Pérez-Fentes
authors: Unidad de Epidemiología Clínica, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
authors: F
authors: F
authors: Gude
authors: Servicio de Urología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
authors: M
authors: M
authors: Blanco-Parra
authors: Servicio de Urología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
authors: E
authors: E
authors: Morón
authors: Servicio de Anestesiología y Reanimación, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
authors: B
authors: B
authors: Ulloa
authors: Servicio de Urología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, España.
authors: C
authors: C
authors: García
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000473:pathology; D000210:Acute-Phase Reaction; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007669:Kidney Calculi / Q000601:surgery / Q000628:therapy; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000473:pathology; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D016207:Cytokines; C508600:IL6 protein, human; D018836:Inflammation Mediators; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein
keywords: Acute-phase reaction; Citoquinas; Cytokines; Cálculos urinarios; Nefrolitotomía percutánea; Percutaneous nephrolithotomy; Respuesta de fase aguda; Urinary calculi