Muhammad Ali Shakir, Khemomal A Karira, Mona Rani, Habibullah Shaikh.
Effect of extracorporeal shockwave lithotripsy (ESWL) on enzymatic and electrolytic levels in renal stone patients.
Med Channel Jan ;16(2):206-10.

OBJECTIVE : To study the effects of Extracorporeal Shockwave Lithotripsy (ESWL) on Enzymatic and Electrolytic level in renal stone patients. STUDY DESIGN : Observational study PLACE AND DURATION : Department of Biochemistry, Basic Medical Sciences Institute (BMSI) , Jinnah Postgraduate Medical Centre (JPMC), with collaboration of Sindh Institute of Urology and Transplantation (SIUT) Karachi, from Feb. 2007 to March 2008. PATIENTS AND METHODS : Twenty males and ten female patients, mean age (35± 9.6 years) with kidney stones 2.0 cms in diameter were investigated for serum Alkaline Phosphatase (ALP), Lactate Dehydrogenase (LDH), Glutamic Oxaloacetic Transaminase (GOT), Glutamic Pyruvate Transaminase (GPT), Electrolytes (Na+,K+,Cl-), Calcium and Phosphorous. 24 Hrs. urine specimens were collected to be tested for urinary Sodium, Potassium, Chloride, Calcium and Phosphorous. Blood and Urine samples were collected before ESWL and Day-1 and Day-5 after ESWL. All serum and urinary parameters were run by commercially available kits from Stanbio Diagnostic, USA using Hitachi system 704 model autoanalyzer. Serum and urinary electrolytes were measured by Ion Selective Electrode (ISE) technology method using “EasyLyte” automated microprocessor controlled analyzer. Data analysis including paired and correlation analysis were computed using SPSS software version 10.0 for windows. P value upto 0.05 was considered significant for all comparisons. RESULTS : Significant increments (p<0.001) in serum levels of ALP, LDH, SGOT, SGPT,and urinary levels of sodium, potassium, chlorides were noted on 1st Post-ESWL day, which reached the highest value on first post-ESWL day and then decreased to the pre-treatment level on 5th Post-ESWL day as the number of shocks increased from 2000- 3500 shockwaves. CONCLUSION : The results suggested that ESWL is not devoid of side-effects. The significant acute trauma to the kidneys and adjacent tissues such as liver, skeletal muscles induced by shockwaves exposure were exhibited by significant increase in cell escaped enzymes and electrolytes and that the extent of damage depends on energy and number of shockwaves exposure.

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