Evaluation of the effect of ureteral access sheet use on acute renal damage in patients undertaking retrograde intrarenal surgery (RIRS) with (MIOX) (Myo-inositol oxygenase) biomarker

Objective: The use of standard ureteral access sheath (UAS) in patients undergoing retrograde intrarenal surgery (RIRS) is controversial. In our study, it was assumed that the use of UAS keeps intra-renal pressure low, considering the studies in the literature, and whether intra-renal pressure directly caused kidney damage was investigated with the myoinocytoloxygenase (MIOX) marker. Materials and Methods: Eighty patients between the ages of 20 and 75 years who underwent RIRS for kidney stones in our clinic between March 2019 and March 2021 were included in our study. The patients were divided into two groups as those who used UAS and those who did not. In this prospective study, patients; demographic characteristics, stone size, stone location, operation times, hospitalization time, operation success, preop and postop urea, creatine, GFR values were recorded. 5 cc blood samples taken from the patients before the operation and at the 4th hour after the operation were centrifuged and kept at -80 ° C and MIOX was measured in the biochemistry department. Results: There was no difference between the groups in terms of demographic data. The stone size and location of the patients included in the study were similar between the groups. The duration of operation and hospitalization time were significantly longer in the group using UAS. No statistical difference was found between the two groups in terms of operation success and development of complications. Groups were evaluated in terms of postop and preop MIOX differences. While the mean change in MIOX was 0.08 ± 0.44ng / ml in patients who underwent RIRC without the use of UAS, this change was measured as -0.29 ± 0.36 ng / ml in patients who underwent RIRS using UAS. No difference was found (p = 0.222). v Conclusion: Although it has been shown in the studies in the literature that the RIRS procedure performed without the use of UAS increases the intrarenal pressure, we think that the RIRS procedure performed without the use of UAS is safe in terms of acute kidney injury. The fact that intrarenal pressures could not be measured in our study limitasion of our study. There is a need for more comprehensive studies evaluating the effect of UAS use on acute kidney injury, including intrarenal pressures.