Assessment of potential acute kidney damage developing after ESWL in children based on urinary KIM-1, NGAL and CYS-C levels

Objective: This study aims to assess the potential acute kidney damage developing after ESWL in children based on urinary KIM-1, NGAL and CYS-C levels, which are considered as the new-generation markers. Material and Methods: A total number of 24 patients aged between 0 and 16 years who were diagnosed with urinary system stones between April 2015 and in this study. Serum urea, creatinin, electrolytes, uric acid levels and urinary electrolytes, KIM-1, NGAL and Cystatin C levels of the patients were analyzed before and 2 hours, 24 hours and 7 days after ESWL treatment. Results: No significant change was noted in serum urea, creatinine, electrolyte or uric acid levels of the patients. The mean urinary calcium level, which was 5.26±3.93 mg/dl before ESWL, increased to 12.31±11.34 mg/dl 24 hours after ESWL (p=0.038). No significant increase was noted in urinary KIM-1 or cystatin-C levels. Mean NGAL level, which was measured as 1806±934 pg/ml before ESWL, increased to 7969±7471 pg/ml and 11864±7557 pg/ml 24 hours and 7 days after ESWL, respectively. Although these elevations in NGAL levels were significant (p=0.005 and p=0.001, respectively), even the highest measurement was found to be within the reference range. Conclusion:Our study findings suggest that as well as several previous studies in the literature investigating ESWL and its effects, ESWL is a considerably effective and safe method for the treatment of childhood urinary system stone disease and does not result in any significant acute kidney damage. Keywords: ESWL, Acute kidney injury, NGAL, KIM-1, CYS-C