Urine cytokine profile and nephroprotective effect of lercanidipine in patients with urolithiasis with obstructive uropathy before and after nephrostomy

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Abstract

Objective. To study the nephroprotective effect of lercanidipine and its influence on creatinine clearance and cytokine damage in patients with urolithiasis with obstructive uropathy.

Material and methods. Of 96 patients evaluated, 66 were diagnosed with kidney stones in the ureteropelvic segment and obstructive uropathy, which was then treated with percutaneous nephrostomy. All 66 patients were given antibacterial and anti-inflammatory therapy to prevent postoperative infections, but in addition, 33 were treated with lercanidipine, 10 mg per day. IL-8, VEGF, MCP-1, G-CSF, and GM-CSF concentrations in the urine were determined by solid-phase ELISA. The estimated glomerular filtration rate was calculated using the CKD-EPI formula. All studies were done preoperatively and on days 7, 14, 21, and 28 after nephrostomy. A control group consisted of 30 people with kidney stones without sings of obstruction.

Results. In the patients with obstructive uropathy, a correlation was found between VEGF, IL-8, and MCP-1 concentrations in the urine and the serum creatinine and estimated glomerular filtration rate. Patients in the lercanidipine group had a faster decrease in IL-8, VEGF, MCP-1, and GM-CSF concentrations in the urine and improved renal function compared with patients who did not receive lercanidipine. By day 21 after nephrostomy, the lercanidipine group had values comparable with the control group, whereas the group not treated with lercanidipine did not achieve similar values until day 28.

Conclusion. The third generation calcium channel blocker lercanidipine is nephroprotective in patients with obstructive uropathy.

About the authors

Vladimir M. Popkov

Saratov State Medical University named after V.I. Razumovsky

Author for correspondence.
Email: meduniv@sgmu.ru

Rector, Professor, Department of Urology, Doctor of Medical Science

Russian Federation, Saratov

Natalia B. Zakharova

Saratov State Medical University named after V.I. Razumovsky

Email: lipidgormon@mail.ru

Professor, Department of Clinical Laboratory Diagnostics, Doctor of Medical Science

Russian Federation, Saratov

Alexander B. Polozov

Saratov State Medical University named after V.I. Razumovsky

Email: meduniv@sgmu.ru

Professor, Department of Urology, Doctor of Medical Science

Russian Federation, Saratov

Anastasiia I. Khotko

Saratov State Medical University named after V.I. Razumovsky

Email: pivovarova-nastya@ya.ru

Postgraduate, Department of Urology

Russian Federation, Saratov

Dmitrii N. Khotko

Saratov State Medical University named after V.I. Razumovsky

Email: pivovarova-nastya@ya.ru

Head, Department of Urology

Russian Federation, Saratov

Denis A. Durnov

Saratov State Medical University named after V.I. Razumovsky

Email: meduniv@sgmu.ru

Assistant of Professor, Department of Urology

Russian Federation, Saratov

References

  1. Hasna A, Meiyappan K, Periyasam SG, et al. Is urolithiasis associated with increased levels of high sensitivity C-reactive protein and interleukin-6 in diabetic patients? J Clin Diagn Res. 2015;9(3):1-3. doi: 10.7860/JCDR/2015/12489.5681.
  2. Wang CJ, Hsu CS, Chen HW, et al. Percutaneous nephrostomy versus ureteroscopic management of sepsis associated with ureteral stone impaction: a randomized controlled trial. Urolithiasis. 2016;44(5):415-419. doi: 10.1007/s00240-015-0852-7.
  3. Ucero AC, Gonçalves S, Benito-Martin A, et al. Obstructive renal injury: from fluid mechanics to molecular cell biology. Open Access J Urol. 2010;2:41-55.
  4. Arakawa T. Surgical management for urolithiasis. Clin Calcium. 2011;21(10):1535-1541. (In Japanese). doi: CliCa111015351541.
  5. Николаев А.Ю. Возможности и перспективы нефропротективной стратегии // Терапевтический архив. - 2012. - № 6. - С. 77-80. [Nikolaev AYu. Vozmozhnosti i perspektivy nefroprotektivnoj strategii. Terapevticheskij arhiv. 2012;(6):77-80. (In Russ.)]
  6. Кукес В.Г., Остроумова О.Д., Стародубцев А.К. Антагонисты кальция: современные аспекты применения в кардиологии // Consilium medicum. - 2006. - № 11. - С. 113-117. [Kukes VG, Ostroumova OD, Starodubtsev AK. Calcium antagonists: modern aspects of the use in cardiology. Consilium medicum. 2006;(11):113-117. (In Russ.)]
  7. Глыбочко П.В., Захарова Н.Б., Понукалин А.Н., и др. Диагностическое значение подъема уровня провоспалительных цитокинов в моче при обострении хронического калькулезного пиелонефрита // Саратовский научно-медицинский журнал. - 2011. - Т. 7 (прил.). - С. 143. [Glybochko PV, Zakharova NB, Ponukalin AN, et al. Diagnostic value of the increased levels of proinflammatory cytokines in the urine during exacerbation of chronic calculous pyelonephritis. Saratovskiy nauchno-meditsinskiy zhurnal. 2011;7(Suppl.):143. (In Russ.)]
  8. Захарова Н.Б., Пастушкова Л.Х., Ларина И.М., и др. Значение протеомного состава мочи при заболеваниях мочевыводящих путей (обзор литературы) // Экспериментальная и клиническая урология. - 2017. - № 1. - C. 22-26. [Zakharova NB, Pastushkova LH, Larina IM, et al. The importance of the proteomic composition of urine in urinary tract diseases. Literature review of literature. Experimental and clinical urology. 2017;(1):22-26. (In Russ.)]
  9. Морозов Д.А., Морозова О.Л., Захарова Н.Б., Лакомова Д.Ю. Патогенетические основы и современные проблемы диагностики хронического обструктивного пиелонефрита у детей // Урология. - 2013. - № 2. - С. 129-134. [Morozov DA, Morozova OL, Zakharova NB, Lakomova DYu. Pathogenetical bases and current problems of diagnosis of chronic obstructive pyelonephritis in children. Urologiia. 2013;(2):129-134. (In Russ.)]
  10. Алексеев А.В., Гильманов А.Ж., Гатиятуллина Р.С., Ракипов И.Г. Современные биомаркеры острого повреждения почек // Практическая медицина. - 2014. - № 3. - С. 22-27. [Alekseev AV, Gilmanov AZh, Gatiyatullina RS, Rakipov IG. Recent biomarkers of acute renal injury. Prakticheskaja medicina. 2014;(3):22-27. (In Russ.)]
  11. Кореньков Д.Г., Марусанов В.Е., Мишина Т.П., Павлов А.Л. Провоспалительные цитокины в определении степени активности хронического пиелонефрита // Урологические ведомости. - 2015. - Т. 5. - № 4. - С. 13-19. [Korenkov DG, Marusanov VE, Mishina TP, Pavlov AL Proinflammatory cytokines in determining the degree of activity of chronic pyelonephritis. Urologicheskie vedomosti. 2015;5(4):13-19. (In Russ.)]
  12. Добронравов В.А. Обзор патофизиологии острого повреждения почек // Смирнов А.В., Добронравов В.А., Румянцев А.Ш. Острое повреждение почек. - М.: МИА, 2015. - C. 30-79. [Dobronravov VA. Overview of the pathophysiology of acute kidney injury. In: Smirnov AV, Dobronravov VA, Rumyantsev AS. Acute kidney injury. Moscow: MIA; 2015. P. 30-79. (In Russ.)]
  13. Damman K, Masson S, Hillege HL, et al. Tubular damage and worsening renal function in chronic heart failure. JACC Heart Fail. 2013;1(5):417-424. doi: 10.1016/j.jchf.2013.05.007.
  14. Крайдашенко О.В., Долинная М.А. Роль биомаркеров в оценке характера повреждений почек у больных гипертонической болезнью // Клиническая нефрология. - 2014. - № 3. - С. 23-25. [Kraydashenko OV, Dolinnaya MA. Biomarkers in assessment of renal involvement in patients with arterial hypertension. Klinicheskaja nefrologija. 2014;(3):23-25. (In Russ.)]
  15. Dendooven A, Ishola DA Jr, Nguyen TQ, et al. Oxidative stress in obstructive nephropathy. Int J Exp Path. 2010;92(3):202-210. doi: 10.1111/j.1365-2613.2010.00730.x.
  16. Семикина Е.Л., Русаков А.А., Филянская Е.Г., и др. Уровень факторов ангиогенеза в моче при одностороннем гидронефрозе у детей раннего возраста - различия концентрации in situ и в мочевом пузыре // Медицинская иммунология. - 2015. - Т. 17, специальный выпуск. - С. 210-211. [Semikina EL, Rusakov AA, Filyanskaya EG, et al. Uroven faktorov angiogeneza v moche pri odnostoronnem gidronefroze u detej rannego vozrasta - razlichija koncentracii in situ i v mochevom puzyre. Medicinskaja immunologija. 2015;17(special issue):210-211. (In Russ.)]
  17. Shiomi A, Usui T. Pivotal Roles of GM-CSF in Autoimmunity and Inflammation. Mediators Inflamm. 2015;2015:1-13. doi: 10.1155/2015/568543.

Supplementary files

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2. Fig. 1. ROC curves to assess sensitivity and specificity for urine VEGF, MCP-1, IL-8, G-CSF, GM-CSF concentrations in patients with urolithiasis and obstructive uropathy

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3. Fig. 2. Change of urine VEGF levels in patients with obstructive uropathy in the first month after nephrostomy and in controls

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4. Fig. 3. Change of urine MCP-1 levels in patients with obstructive uropathy in the one month after nephrostomy and in controls

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5. Fig. 4. Change of urine IL-8 levels in patients with obstructive uropathy in the one month after nephrostomy and in controls

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6. Fig. 5. Change of urine GM-CSF levels in patients with obstructive uropathy in the one month after nephrostomy and in controls

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7. Fig. 6. Renal function in patients with obstructive uropathy before and after nephrostomy by treatment group. a: creatinine level (μmol/L); b: eGFR by CKD-EPI (mL/min)

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Copyright (c) 2018 Popkov V.M., Zakharova N.B., Polozov A.B., Khotko A.I., Khotko D.N., Durnov D.A.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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