Assessment of Plasma Homocysteine as a Marker of Acute Renal Injury in Patients Undergoing Extracorporeal Shock Wave Lithotripsy (ESWL) for Renal Stone Disease

Abstract

Background: Extracorporeal shock wave lithotripsy (ESWL) is a common non-invasive procedure used for the treatment of renal stones. However, it can lead to acute renal injury (ARI), a potential complication that may be overlooked. Plasma homocysteine, an amino acid involved in various metabolic pathways, has been suggested as a potential biomarker for kidney damage. This study aimed to assess plasma homocysteine levels as a marker of ARI in patients undergoing ESWL.

Methods: A total of 100 patients with renal stones undergoing ESWL treatment were enrolled. Plasma homocysteine levels were measured before and after the procedure. Renal function was monitored through serum creatinine levels and estimated glomerular filtration rate (eGFR) to determine the presence of acute renal injury.

Results: Elevated plasma homocysteine levels were significantly associated with post-ESWL ARI. The sensitivity and specificity of plasma homocysteine as a biomarker for ARI were found to be moderate, indicating its potential as a supplementary marker for early detection of kidney injury.

Conclusion: Plasma homocysteine is a useful biomarker for assessing acute renal injury in patients undergoing ESWL. Its role as a diagnostic tool could help in early detection and management of ESWL-related kidney damage.

Keywords: plasma homocysteine, acute renal injury, ESWL, renal stone disease, biomarker