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Review paper
Received: 06.05.2019. >> Accepted: 12.06.2019. >> Published: 10.05.2019. Biochemistry
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https://doi.org/10.17392/1036-19

Short-term changes in renal function in children and adolescents undergoing extracorporeal shock wave lithotripsy

By
Emir Milišić Orcid logo ,
Emir Milišić
Contact Emir Milišić

Clinic of Paediatric Surgery, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Department of Surgery, School of Medicine, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina

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Zlatan Zvizdić ,
Zlatan Zvizdić

Clinic of Paediatric Surgery, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina

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Asmir Jonuzi ,
Asmir Jonuzi

Clinic of Paediatric Surgery, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina

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Edin Begić ,
Edin Begić

Department of Cardiology, General Hospital “Prim. dr. Abdulah Nakaš”, Sarajevo, Bosnia and Herzegovina

Department of Pharmacology, School of Medicine, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina

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Lejla Milišić ,
Lejla Milišić

Clinic of Radiology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

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Amira Mešić
Amira Mešić

Clinic of Anaesthesiology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

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Abstract

Aim
To identify short-term effects of extracorporeal shock wave lithotripsy (ESWL) on renal function in children and adolescents with single kidney stones.
Methods
 In a 4-year period 30 children (15 boys and 15 girls) from 10 to 18 years of age were treated for unilateral renal stones with ESWL. Inclusion criteria were: up to 18 years of age, kidney stone (from 4 to 20 mm in diameter) visible on X-ray, first ESWL treatment, unilateral lithotripsy treatment without previous kidney surgery, patients without infravesical obstruction, patients without proven urinary infection, repeated use of one (the same) analgesic, patients without anticoagulant and antihypertensive therapy, patients without use of nephrotoxic drugs prior to and during the treatment, normal blood pressure, non-pregnancy patients with normal renal function. Serum enzymes (alkaline phosphatase, lactate dehydrogenase), cystatin C, serum and urine electrolytes (sodium, potassium, chloride), and urine neutrophil gelatinase-associated lipocalin (uNGAL) were tested before, on the first and fifth day after the treatment.
Results
 An increase of alkaline phosphatase and lactate dehydrogenase was statistically significant on day 1 (p<0.05) and values returned to normal on day 5. Serum cystatin C level was also significantly increased during the first four days after ESWL treatment (p<0.05) and returned to baseline on post-treatment day 5. There was a statistically significant difference in the level of uNGAL in urine before and 24 hours after ESWL treatment (p<0.05).
Conclusion
The ESWL is a safe and curative procedure for the treatment of kidney stones in children and adolescents with no evidence of serious adverse effects on renal function.

Keywords:

electrolytes,
lithotripsy,
urolithiasis

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