Naslov
Urinary obstruction depresses erythropoiesis which recovers after parenchimal saving open surgery but not ESWL

Autori
Eterović, Davor ; Šitum, Marijan ; Punda, Ante ; Marković, Vinko

Izvornik
Research and Reports in Urology (2253-2447) 38 (2010); 51-56

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
ESWL ; kidney stone ; erythropoiesis ; Epo ; RBC

Sažetak
Background. We have previously shown that that the effects of chronic urolithiasis on renal function and blood pressure are potentially reversible and that the ameliorating effects of relief of obstruction follow the open surgery that saves the renal parenchyma, but not the extracorporeal shock wave lithotripsy (ESWL). Here we tested the hypothesis that chronic human urinary obstruction impairs the renal regulation of the red blood cell (RBC) production, which is also potentially reversible. Methods. We measured RBC count and serum erythropoietin (Epo) concentration before and 3 months after relief of urinary obstruction in 60 patients treated with pyelolithotomy, ureterolithotomy or ureteroscopy and in 62 patients treated with ESWL. Findings. Compared with 333 healthy controls, at baseline, patients scheduled for open surgery had lowered RBC count (9.9% (6.9-13.1%) ; 95% confidence interval) in case of males and 17.7% (14.2-21.4%) ; in case of females, and so had the female patients scheduled for ESWL, albeit to a minor extent. Epo serum levels were mildly reduced in ESWL patients and halved in open surgery group. At 3 months following relief of obstruction in 50 operated patients without recurrent or residual stone, Epo levels almost doubled, becoming normal, while RBC count and haemoglobin concentration increased for 6.1% (3.8-8.8%) and 8.8% (6.1-10.6%) ; on the contrary, in 49 ESWL patients only minor, bidirectional responses to treatment were observed. Interpretation. Obstructive uropathy is associated with clinically relevant effects on erythropoiesis, which is reversed after relief of obstruction by open surgery that saves the renal parenchima.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

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