Urinary obstruction depresses erythropoiesis which recovers after parenchyma-saving surgery but not SWL (CROSBI ID 163329)
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Podaci o odgovornosti
Eterović, Davor ; Šitum, Marijan ; Punda, Ante ; Marković, Vinko ; Kokić, Slaven
engleski
Urinary obstruction depresses erythropoiesis which recovers after parenchyma-saving surgery but not SWL
We tested the hypotheses that chronic human urinary obstruction impairs the renal regulation of the red blood cell (RBC) production and compared the chronic outcome of relief of obstruction between parenchim-saving surgery and extracorporeal lithotripsy (SWL). 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 SWL. Compared with 333 healthy controls, at baseline, patients scheduled for parenchim-saving 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 SWL, albeit to a minor extent. Epo serum levels were mildly reduced in SWL patients and halved in parenchim-saving 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 SWL patients only minor, bidirectional responses to treatment were observed. We conclude that obstructive uropathy is associated with clinically relevant effects on erythropoiesis, which is reversed after relief of obstruction by parenchim-saving surgery that saves the renal parenchima.
kidney stone ; renal obstruction ; lithotripsy ; Epo ; anemia
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Podaci o izdanju
Povezanost rada
Temeljne medicinske znanosti, Kliničke medicinske znanosti