Investigation of rats after ESWL oxidative stress damage in kidney damage the protective effect of N-acetyl cysteine

Aim: The aim of this study was to evaluate the possible effects of renal extracorporeal shock wave lithotripsy (ESWL) on the plasma oxidative stress index (OSI) as a marker for oxidative stress, and to obseve the histopathological changes that occur in the kidneys. Secondly, the protective role of N-acetyl-cysteine administration was evaluatied. Material-method: The current study included 24 rats. These rats divided into 3 groups as the control group (Group I, n:6), ESWL group (Group II, n:9), and ESWL+NAC group (Group III, n:9). All groups were further divided into two subgroups as short-term and long-term. In Groups II and III, contrast material was administered through an intravenous catheter that was placed in the vein of the rat tail, and a collecting system was visualized under fluoroscopy with general anesthesia. A total of 2000 shock waves were applied to the left kidney with at an amplitude of 18 kV and a rate of 60 SW/minute. From the 1st day after ESWL, intraperitoneal saline at a dose of 1 ml/kg/day was administered to the rats in Group II, intraperitoneal N-acetyl cysteine at a dose of 300 mg/kg/day was given to Group III and no treatment was administered to Group I. Blood samples were taken and left nephrectomy specimens were obtained for blood biochemical analyses and histopathological examinations on the 14th day following ESWL in the short-term subgroups and on the 28th day following ESWL in the long-term subgroups, respectively. Acute and chronic damage were evaluated individually. Tubular damage, interstitial inflammation and hemorrhage, dilatation-congestion in the glomerular and vascular structures, increase in inflammatory cells, tubular atrophy, and interstitial fibrosis were examined for histopathological damage. The oxidative stress index (OSI) was calculated by measuring plasma total antioxidant status (TAS) and total oxidant status (TOS). Results: In the group in which NAC was administered following ESWL (Group III), TOS levels were significantly lower (p = 0.027) and TAS levels were significantly higher (p =0.006). As a result, OSI was lower (p =0.013). This effect was particularly significant in the short-term sugroup. It was also concluded that tubular damage was higher in the ESWL group (p=0.022). No significant difference was observed between the median values of the groups in terms of interstitial inflammation, congestion, increase in inflammatory cells, fibrosis, and atrophic changes. Conclusion: Current study demonstrated that ESWL can cause oxidative stress and tubular damage by increasing free oxygen radical production. NAC was effective in decreasing ESWL-induced oxidative stress and tubular damage. Key words: Extracorporeal shock wave lithotripsy, kidney, oxidative stress, rat