Evaluation and physiopathology of minor transient shock wave lithotripsy - induced renal injury based on urinary biomarkers levels

Introduction Extracorporeal shock wave lithotripsy (ESWL) is one of the most useful methods available for the treatment of urolithiasis. However, despite its significant benefits, adverse effects can occur. Oxidative stress mediated by ischemia-reperfusion might contribute to kidney injury after ESWL. Moreover, an acute kidney injury (AKI) may develop. AKI is typically diagnosed by measuring serum creatinine level, yet serum creatinine does not allow for early detection of sub-clinical AKI. The latest report has investigated multiple ways to determine ESWL-induced renal damage through the evaluation of various urine biomarkers of renal injury. Materials and methods The Medline and Web of Science databases were searched without a time limit in November 2017 using the terms 'ESWL' in conjunction with 'kidney failure', 'kidney damage, 'renal injury' and 'inflammation markers', 'biomarkers'. Boolean operators (NOT, AND, OR) were also used in succession to narrow and broaden the search. In this review, we described all the up-to-date reported urine markers of ESWL-induced renal damage. Results In recent years, several studies demonstrated evaluation of ESWL-induced renal injury based on urinary biomarkers levels and its utility in clinical practice. They have a beneficial role in the early detection of AKI, as well as in observation of a transition of this acute illness into chronic kidney disease. Conclusions Different markers have been evaluated in the urine before and after the ESWL treatment, but their number is still limited and results remain inconclusive. Further investigations are mandatory.