Abstract
BackgroundThe number of patients diagnosed and subsequently treated for kidney stones is increasing, and as such the number of post-operative complications is likely to increase. At present, little is known about the role of specific biomarkers, following flexible ureterorenoscopy (FURS) for the surgical treatment of kidney stones. The main aim of the study was to evaluate the role of kidney and infection biomarkers, in patients undergoing FURS.MethodsIncluded were 37 patients (24 males, 13 females), who underwent elective FURS, for the treatment of kidney stones. Venous blood samples were collected from each patient: pre-operatively, and at 30 min, 2 and 4 h post-operatively. Changes to kidney (NGAL, Cystatin-C) and infection (MPO, PCT) biomarkers was quantified by means of ELISA, Biomerieux mini-vidas and Konelab 20 analysers.ResultsFour patients developed post-operative complications (3 - UTIs with urinary retention, 1 - urosepsis. NGAL concentration increased significantly following FURS (p = 0.034). Although no significant changes were seen in Cystatin C, MPO and PCT (p ≥ 0.05) some key clinical observation were noted. Limiting factors for this study were the small number of patients recruited and restriction in blood sampling beyond 4 h.ConclusionsAlthough not confirmative, changes seen to biomarkers such as Cystatin C, NGAL and MPO in our observational clinical pilot-study may warrant further investigation, involving larger cohorts, to fully understand the role of these biomarkers and their potential association with post-operative complications which can develop following FURS.
Highlights
The number of patients diagnosed and subsequently treated for kidney stones is increasing, and as such the number of post-operative complications is likely to increase
Conclusions: not confirmative, changes seen to biomarkers such as Cystatin C, Neutrophil gelatinase-associated lipocalin (NGAL) and MPO in our observational clinical pilot-study may warrant further investigation, involving larger cohorts, to fully understand the role of these biomarkers and their potential association with post-operative complications which can develop following Flexible ureterorenoscopy (FURS)
Effect on Cystatin C concentration The results are expressed as mg/ml and represent changes to serum Cystatin C following FURS (Fig. 1)
Summary
The number of patients diagnosed and subsequently treated for kidney stones is increasing, and as such the number of post-operative complications is likely to increase. In the UK, patients have been monitored post-operatively using routine blood tests, such as the full blood count, urea and electrolyte and C reactive protein (CRP) These traditional blood tests are clinically useful, they are non-specific in nature, and fail to identify patients at increased risk of developing postoperative complications, such as infection and acute kidney injury. There is limited literature and evidencebased reports highlighting the role of specific biomarkers, which can monitor patients following FURS It is anticipated, in the future, that a specific panel of biomarkers (or biomarker profile) may help aid clinicians in the monitoring of patients undergoing FURS and could help identify or predict those individuals at increased risk of developing complications post-procedure
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