Extracorporeal Shockwave Lithotripsy (ESWL) for Urolithiasis : Evaluation of Tissue Injury by Measuring Serum and Urine 28-kDa Calbindin-D

Abstract

28-kDa Calbindin-D is a vitamin D dependent calcium binding protein which is mainly localized in the distal renal tubules and central nervous tissue in human tissues. To clarify the extent to which the extracorporeal shockwave lithotripsy (ESWL) for urolithiasis damages renal tissues, we immunoassayed 28-kDa Calbindin-D in the serum and urine from patients with renal stone (n=21) and ureteral stone (n=18) before and after (0, 2 and 24 hours) ESWL. The concentrations of 28-kDa Calbindin-D were enhanced significantly after ESWL as follows. 1) In patients with renal stone : 0, 2 and 24 hours after ESWL in serum ; 0 and 2 hours after ESWL in urine. Serum concentrations of 28-kDa Calbindin-D in patients with renal stone were significantly higher than those of ureteral stone at 0, 2 and 24 hours after ESWL. In contrast, no significant difference was found in the urine concentration of 28-kDa Calbindin-D between both patients. These findings suggest that (1) ESWL for renal stone might damage distal renal tubules and that (2) ESWL for ureteral stone might also cause a distal renal tubular injury, but specific marker reflects distal renal tubular injury by ESWL for urolithiasis.