PDF(Pubmed)
Abstract：
UNASSIGNED: Observational studies on the association of endourological procedures with renal parenchymal damage are lacking. This randomized trial examined the effect of standard percutaneous nephrolithotomy (sPCNL) in comparison with miniaturized-PCNL (mini-PCNL) and retrograde intrarenal surgery (RIRS) for nephrolithiasis treatment on novel biomarkers of renal injury.
UNASSIGNED: Seventy-five patients were randomized in a 1:1:1 ratio to receive sPCNL, mini-PCNL and RIRS for nephrolithiasis. The ratios of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) and interleukin-18 (IL-18) normalized for urinary creatinine (Cr) were calculated from urine samples collected at baseline (2-h preoperatively) and at 2-, 6-, 24- and 48-h postoperatively. Two-way mixed analysis of variance (ANOVA) for repeated measurements was used to evaluate the effects of type of procedure and time on studied biomarkers.
UNASSIGNED: Between baseline and 2-h postoperatively, no significant differences were observed in NGAL/Cr changes between sPCNL [median (interquartile range) 9.46 (4.82-14.9)], mini-PCNL [12.78 (1.69-25.24)] and RIRS [6.42 (2.61-23.90)] (P = .902). Similarly, no between-group differences were observed for KIM-1/Cr (P = .853) and IL-18 (P = .980) at 2 h, and all biomarkers at any time-point postoperatively. Within-groups, significant increases from baseline were noted for NGAL/Cr (sPCNL, P < .001; mini-PCNL, P < .001; RIRS, P = .001), KIM-1/Cr and IL-18/Cr at 2 h; progressively lower increases from baseline were noted in all groups for KIM-1/Cr and IL-18/Cr at 6-, 24- and 48-h postoperatively. As such, a significant effect of time but not of type of procedure was evidenced with two-way mixed ANOVA. No significant between-group differences were observed in acute kidney injury incidence and complications.
UNASSIGNED: The endourological procedures under study are associated with similar patterns of early tubular injury, detected by novel biomarkers, which is largely reduced within 48 h and no changes in glomerular function.
UNASSIGNED: Seventy-five patients were randomized in a 1:1:1 ratio to receive sPCNL, mini-PCNL and RIRS for nephrolithiasis. The ratios of neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1) and interleukin-18 (IL-18) normalized for urinary creatinine (Cr) were calculated from urine samples collected at baseline (2-h preoperatively) and at 2-, 6-, 24- and 48-h postoperatively. Two-way mixed analysis of variance (ANOVA) for repeated measurements was used to evaluate the effects of type of procedure and time on studied biomarkers.
UNASSIGNED: Between baseline and 2-h postoperatively, no significant differences were observed in NGAL/Cr changes between sPCNL [median (interquartile range) 9.46 (4.82-14.9)], mini-PCNL [12.78 (1.69-25.24)] and RIRS [6.42 (2.61-23.90)] (P = .902). Similarly, no between-group differences were observed for KIM-1/Cr (P = .853) and IL-18 (P = .980) at 2 h, and all biomarkers at any time-point postoperatively. Within-groups, significant increases from baseline were noted for NGAL/Cr (sPCNL, P < .001; mini-PCNL, P < .001; RIRS, P = .001), KIM-1/Cr and IL-18/Cr at 2 h; progressively lower increases from baseline were noted in all groups for KIM-1/Cr and IL-18/Cr at 6-, 24- and 48-h postoperatively. As such, a significant effect of time but not of type of procedure was evidenced with two-way mixed ANOVA. No significant between-group differences were observed in acute kidney injury incidence and complications.
UNASSIGNED: The endourological procedures under study are associated with similar patterns of early tubular injury, detected by novel biomarkers, which is largely reduced within 48 h and no changes in glomerular function.
摘要：
■缺乏关于内泌尿手术与肾实质损害的相关性的观察性研究。这项随机试验研究了标准经皮肾镜取石术（sPCNL）与微型PCNL（mini-PCNL）和逆行肾内手术（RIRS）治疗肾结石对新型肾损伤生物标志物的影响。
■75名患者以1:1:1的比例随机接受sPCNL，mini-PCNL和RIRS治疗肾结石。中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的比率，肾损伤分子-1（KIM-1）和白细胞介素-18（IL-18）的尿肌酐（Cr）归一化计算从尿液样本收集在基线（2小时术前）和2-，6-，术后24小时和48小时。使用用于重复测量的双向混合方差分析(ANOVA)来评估程序类型和时间对所研究的生物标志物的影响。
■在基线和术后2小时之间，sPCNL之间的NGAL/Cr变化没有显着差异[中位数（四分位距）9.46（4.82-14.9）]，迷你PCNL[12.78（1.69-25.24）]和RIRS[6.42（2.61-23.90）]（P=.902）。同样，在2小时时，KIM-1/Cr（P=.853）和IL-18（P=.980）没有观察到组间差异，以及术后任何时间点的所有生物标志物。群体内部,NGAL/Cr从基线显着增加(sPCNL，P<.001;小型PCNL,P<.001;RIRS,P=.001)，在2h时KIM-1/Cr和IL-18/Cr;在6-时，所有组的KIM-1/Cr和IL-18/Cr从基线逐渐降低。术后24小时和48小时。因此，双向混合方差分析证明了时间的显著影响,而不是手术类型的显著影响.两组间急性肾损伤发生率及并发症差异无统计学意义。
■正在研究的腔内手术与早期肾小管损伤的相似模式有关，通过新的生物标志物检测，在48小时内大幅减少，肾小球功能无变化。
■75名患者以1:1:1的比例随机接受sPCNL，mini-PCNL和RIRS治疗肾结石。中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的比率，肾损伤分子-1（KIM-1）和白细胞介素-18（IL-18）的尿肌酐（Cr）归一化计算从尿液样本收集在基线（2小时术前）和2-，6-，术后24小时和48小时。使用用于重复测量的双向混合方差分析(ANOVA)来评估程序类型和时间对所研究的生物标志物的影响。
■在基线和术后2小时之间，sPCNL之间的NGAL/Cr变化没有显着差异[中位数（四分位距）9.46（4.82-14.9）]，迷你PCNL[12.78（1.69-25.24）]和RIRS[6.42（2.61-23.90）]（P=.902）。同样，在2小时时，KIM-1/Cr（P=.853）和IL-18（P=.980）没有观察到组间差异，以及术后任何时间点的所有生物标志物。群体内部,NGAL/Cr从基线显着增加(sPCNL，P<.001;小型PCNL,P<.001;RIRS,P=.001)，在2h时KIM-1/Cr和IL-18/Cr;在6-时，所有组的KIM-1/Cr和IL-18/Cr从基线逐渐降低。术后24小时和48小时。因此，双向混合方差分析证明了时间的显著影响,而不是手术类型的显著影响.两组间急性肾损伤发生率及并发症差异无统计学意义。
■正在研究的腔内手术与早期肾小管损伤的相似模式有关，通过新的生物标志物检测，在48小时内大幅减少，肾小球功能无变化。
