Skip to main content
Log in

Leucine aminopeptidase enzymuria: Quantification of renal tubular damage following extracorporeal shock wave lithotripsy

  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

To evaluate the extent of renal parenchymal injury following high energy shock wave (HESW) application we measured the urine levels of two renal tubular brush border enzymes: leucine aminopeptidase (LAP) and γ-glutamyltranspeptidase (GGT) the day before, 24 hours and 7 days after extracorporeal shock wave lithotripsy (ESWL) in 23 patients. All patients had caliceal stones and were treated with a Dornier MPL 9000 lithotriptor under sedoanalgesia. Creatinine concentration of each sample together with total shock wave effect (TSWE) values were also assessed and comparatively evaluated with enzymuria levels.

Our results indicated a statistically significant rise in urinary excretion of both enzymes after 24 hours following lithotripsy (p<0.05). All these values returned to normal limits within 7 days after ESWL (p>0.05). Transient tubular damage due to HESW was found to be related to TSWE values assessed in our group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Lingeman, J. E., Newman, D., Mertz, J. H. O., Moshough, P. G., Steele, R. E., Kahnoski, R. J., Coury, T. A., Woods, J. R.: ESWL; The Methodist Hospital of Indiana experience.J. Urol., 135, 1134 (1986).

    PubMed  CAS  Google Scholar 

  2. Karlin, S. G., Schulsinger, D., Urivetsky, M., Smith, A. D.: Absence of persisting parenchymal damage after ESWL as judged by excretion of renal tubular enzymes.J. Urol., 144, 13 (1991).

    Google Scholar 

  3. Recker, F., Hofmann, W., Bex, A., Tscholl, R.: Quantitative determination of urinary marker proteins: A model to detect intrarenal bioeffects after ESWL.J. Urol., 148, 1000 (1992).

    PubMed  CAS  Google Scholar 

  4. Kande, J. V., Williams, C. M., Millner, M. R., Scott, K. N., Finlayson, B.: Renal morphology and function immediately after ESWL.AJR, 145, 305 (1985).

    Google Scholar 

  5. Karlsen, S. J., Berg, K. J.: Acute changes in kidney function following ESWL for renal stones.Br. J. Urol., 67, 241 (1991).

    Article  PubMed  CAS  Google Scholar 

  6. Williams, C. M., Kaude, J. C., Miles, S. G.: The incidence of stones, decreased renal function and hypertension after ESWL: A long-term follow-up study.J. Nucl. Med., 28, 764 (1987).

    Google Scholar 

  7. Recker, F., Rubben, H., Bex, A., Costantinidis, C.: Morphological changes following ESWL in the rat kidney.Urol. Res., 17, 229 (1989).

    PubMed  CAS  Google Scholar 

  8. Kishimoto, T., Senju, M., Sugimoto, T., Yamamoto, K.: Effect of high energy shock wave exposure on renal function during extracorporeal shock wave lithotripsy for kidney stones.Eur. Urol., 18, 290 (1990).

    PubMed  CAS  Google Scholar 

  9. Bedük, Y., Erden, I., Göĝüş, O., Sarica, K., Aytaç, S., Karalezli, G.: Evaluation of renal morphology and vascular function by color flow doppler sonography immediately after ESWL.J. Endourol., 7, (6), 457 (1993).

    PubMed  Google Scholar 

  10. Jung, K., Brieng, M., Kirschner, P., Schroder, K., Schmiedel, T.: Excretion of urinary enzymes after ESWL.Tech. Br. Clin. Chem., 33, 2000 (1989).

    Google Scholar 

  11. Hasegawa, S., Kato, K., Takashi, M., Zhu, Y.: S100Ao protein as a marker for tissue damage related to extracorporeal shock wave lithotripsy.Eur. Urol., 24, 393 (1993).

    PubMed  CAS  Google Scholar 

  12. Jung, K., Kirschner, P., Wille, A., Brien, G.: Excretion of urinary enzymes after extracorporeal shock wave lithotripsy: A critical reevaluation.J. Urol., 149 1409 (1993).

    PubMed  CAS  Google Scholar 

  13. Metz, U., Graben, N., Maruhn, D., Bock, K.: Urinary enzyme excretion after single dose of phenacetin and paracetamol (acetaminophen) during antidiuresis and during water diuresis.Clin. Chem. Acta, 160, 151 (1986).

    Article  CAS  Google Scholar 

  14. Raab, P. W.: Diagnostic value of urinary enzyme determination.Clin. Chem., 188, 5 (1972).

    Google Scholar 

  15. Patterson, E. K., Hsiao, S. H., Keppel, A.: Studies on dipeptidases and aminopeptidases: Distinction between leucine aminopeptidase and enzymes that hydrolyse 1-leucyl-β-naphthylamide.J. Biol. Chem., 238, 361 (1963).

    Google Scholar 

  16. Knapp, P. M., Scott, J. W.: Magnetic resonance imaging following ESWL.J. Urol., 137, Abstract 732 (1987).

    Google Scholar 

  17. Szasz, G.: γ-Glutamyltranspeptidase Aktivität im Urin.Z. Klin. Chem. Klin. Biochem., 8, 1 (1970).

    PubMed  CAS  Google Scholar 

  18. Johnston, I. D., Norman, F., Scable, J., Yuen, C. T., Price, R. G.: The diagnostic value of urinary enzyme measurements in hypertension.Clin. Chem. Acta, 133, 317 (1983).

    Article  CAS  Google Scholar 

  19. Jung, K., Schulze, G., Reinholdt, C.: Different diuresis-dependent excretions of urinary enzymes: N-acetyl-D-glucosaminidase, alanine aminopeptidase, alkaline phosphatase and γ-glutamyltransferase.Clin. Chem., 32 (3), 529 (1986).

    PubMed  CAS  Google Scholar 

  20. Kishimoto, T., Yamamoto, K., Sugimoto, T.: Side effects of ESWL exposure in patients treated by ESWL for upper urinary tract stones.Eur. Urol., 12, 308 (1986).

    PubMed  CAS  Google Scholar 

  21. Weber, A., Köhrmann, K. U., Kahmann, F. U., Rassweiler, J., Alken, P.: Lithotriptorenvergleich anhand eines standardisierten in-vitro Steinmodels.Z. Urol., 4, 170 (1992).

    Google Scholar 

  22. Whelan, J. P., Finlayson, B.: An experimental model for the systematic investigation of stone fracture by ESWL.J. Urol., 140, 395 (1988).

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sarica, K., Süzer, O., Yaman, Ö. et al. Leucine aminopeptidase enzymuria: Quantification of renal tubular damage following extracorporeal shock wave lithotripsy. International Urology and Nephrology 28, 621–626 (1996). https://doi.org/10.1007/BF02552155

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02552155

Keywords

Navigation