Clinical Study Changes Of Biochemical Markers Of Renal Injury Before ESWL

Objective Patients with urinary calculi who were taken extracorporeal shock wave lithotripsy(ESWL) before and after gravel treatment were detected biochemical indexes,to seek a better biochemical detection indicator of early prediction ESWL renal injury.And to determine the situation of kidney damage and repair,also to provide laboratory basis for the interval between two ESWL.Method Screening 60 patients with kidney stones who were taken ESWL in our hospital between February 2014 to May 2014,collecting respectively in patients with preoperative and postoperative 0 h, 6 h, 12 h, 24 h, 48 h, 1 w, 2 w urine specimens,to measure their cystatin C(Cys C), beta 2- microglobulin(beta 2- MG), alpha 1- microglobulin(alpha 1- MG),and to proceed statistical analysis.Result There were significant changes in postoperative biochemical indicators compared with preoperative of 60 patients taken ESWL, and which showed a certain regularity. Urine Cys C increased significantly after ESWL 6 hours, the difference had statistically significance(P <0.05), after 6 hours it still on the rise, then to reach the highest point at after ESWL 24 h. There were statistically significance(P <0.05) compared with before the surgery, the content of urine Cys C appeared a slow decline after 24 h, urine Cys C still remained statistically significance(P <0.05) when compared with preoperative levels at 48 h, the content of urine Cys C had significantly reduced at 1W postoperative follow-up, but compared with preoperative levels were still significant difference(P <0.05), 2W postoperative follow-up, the content of urine Cys C had dropped close to preoperative levels, and no significant difference(P> 0.05) compared with before surgery. β2- MG appeared rising at after surgery 24 h, there were statistically difference(P <0.05) compared with the preoperative, 48 h reached a peak and then dropped down to near normal levels at 1W postoperative follow-up, and no statistically difference(P>0.05) compared with the preoperative, then down to a lower level when 2W follow-up. α1- MG also appeared rising at after surgery 24 h, there were statistically difference(P <0.05) compared with the preoperative, 48 h reached a peak, dropped to normal levels at 1W postoperative follow-up, the difference was not statistically significance(P> 0.05).Conclusion This experiment shows that the urine Cys C can detect early kidney injury earlier than the other two kinds of indicators, and presents a certain regularity, with high sensitivity, to provide an objective basis for clinical diagnosis and treatment of kidney damage. β2- microglobulin and α1- microglobulin can also detect early kidney damage, but somewhat less sensitive; This study also considers that patients after ESWL should not be taken lithotripsy within the line again in 2W.