Dursun BABA
(Atatürk Devlet Hastanesi, Üroloji Kliniği, Düzce, Türkiye)
H. Kamil ÇAM
(Marmara Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, İstanbul, Türkiye)
Yusuf ŞENOĞLU
(Düzce Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Düzce, Türkiye)
Alpaslan YÜKSEL
(Düzce Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, Düzce, Türkiye)
Havva ERDEM
(Ordu Üniversitesi, Tıp Fakültesi, Patoloji Anabilim Dalı, Ordu, Türkiye)
Ekrem BAŞARAN
(Atatürk Devlet Hastanesi, Üroloji Kliniği, Düzce, Türkiye)
Yıl: 2020Cilt: 7Sayı: 1ISSN: 2148-9580Sayfa Aralığı: 8 - 15İngilizce

30 0
The Efficacy of N-acetylcysteine Against Renal Oxidative Stress After Extracorporeal Shock Wave Treatment: An Experimental Rat Model
Objective: To evaluate effects of renal extracorporeal shock wave lithotripsy (SWL) on plasma Oxidative Stress index (OSI) and to observe histopathological alterations in an experimental model. Secondly, protective role of N-acetylcysteine (NAC) was investigated. Materials and Methods: A total of 24 rats were randomly divided into 3 groups as control (group 1), SWL + saline (group 2), and SWL + NAC (group 3). Study groups were further divided into two subgroups as short-term and long-term. In groups 2 and 3, 2000 shock waves were applied. Intraperitoneal saline was administered in group 2, and intraperitoneal NAC was given to group 3. No treatment was administered to group 1. Blood samples and nephrectomy specimens were obtained for biochemical and histopathological examinations, respectively. OSI was calculated by measuring plasma total antioxidant status (TAS) and total oxidant status (TOS). Acute and chronic histopathological damage were evaluated by light microscopy. Results: SWL caused a remarkable increase in oxidative stress. Strikingly, TOS levels were significantly lower (p=0.027) and TAS levels were significantly higher (p=0.006) in rats with SWL + NAC (group 3). As a result, OSI was lower (p=0.013). This effect was particularly significant in the short-term subgroup. It was also concluded that tubular damage and interstitial inflammation were higher in the SWL group (p=0.022). These acute histological alterations were slighter in rats with NAC. Conclusion: The current study demonstrated that SWL can cause severe oxidative stress and acute renal damage by increasing free oxygen radical production. NAC was effective in decreasing SWL-induced oxidative stress and preventing certain histological alterations to some extent.
DergiAraştırma MakalesiErişime Açık
  • 1. Matlaga BR, Assimos DG. Changing indications of open stone surgery. Urology 2002;59:490-493.
  • 2. Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol 2016;69:475-482.
  • 3. Aksoy H, Aksoy Y, Turhan H, Keleş S, Ziypak T, Ozbey I. The effect of shock wave lithotripsy on nitric oxide and malondialdehyde levels in plasma and urine samples. Cell Biochem Funct 2007;25:533-536.
  • 4. Park JK, Cui Y, Kim MK, Kim YG, Kim SH, Kim SZ, Cho KW. Effects of extracorporeal shock wave lithotripsy on plasma levels of nitric oxide and cyclic nucleotides in human subjects. J Urol 2002;168:38-42.
  • 5. Sarica K, Koşar A, Yaman Ö, Bedük Y, Durak I, Kavukçu M. Evaluation of ischemia after ESWL: detection of free oxygen radical scavenger enzymes in renal parenchyma subjected to high-energy shock waves. Urol Int 1996;57:221-223.
  • 6. Ozguner F, Armagan A, Koyu A, Calıskan S, Koylu H. A novel antioxidant agent caffeic acid phenethyl ester prevents shock wave-induced renal tubular oxidative stress. Urol Res 2005;33:239-243.
  • 7. Li X, He D, Zhang L, Cheng X, Sheng B, Luo Y. A novel antioxidant agent, astragalosides, prevents shock wave-induced renal oxidative injury in rabbits. Urol Res 2006;34:277-282.
  • 8. Zafarullah M, Li WQ, Sylvester J, Ahmad M. Molecular mechanisms of N-acetylcysteine actions. Cell Mol Life Sci 2003;60:6-20.
  • 9. De Stefani S, Micali S, De Carne C, Sighinolfi MC, Di Pietro C, Marzona L, Volpi N, Bianchi G. Shockwave lithotripsy and protective role of inosine: early and late evaluation in an experimental model. J Endourol 2008;22:1059-1063.
  • 10. Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem. 2005;38:1103-1111.
  • 11. Erel O. A novel automated method to measure total antioxidant response against potent free radical reactions. Clin Biochem 2004;37:112-119.
  • 12. Li X, Xue Y, He D, Chen X, Zhang L. Shock wave induces chronic renal lesion through activation of the nuclear factor kappa B signaling pathway. World J Urol 2010;28:657-662.
  • 13. Akgüllü Ç, Saruhan T, Eryilmaz U, Boyacıoğlu , Onbaşılı OA, Meteoğlu I, Kum C. The first histopathological evidence of trimetazidine for the prevention of contrast-induced nephropathy. Ren Fail 2014;36:575-580.
  • 14. Li X, He DL, Cheng XF, Zhang LL, Yu LH, Li JJ. Effects of components isolated from Astragalus mongholicus on expression of p-selectin in shock wave induced kidney injury in rabbit model. Zhongguo Zhong Yao Za Zhi 2005;30:1606-1609.
  • 15. Al-Awadi KA, Kehinde EO, Loutfi I, Mojiminiyi OA, Al-Hunayan A, AbdulHalim H, Al-Sarraf A, Memon A, Abraham MP. Treatment of renal calculi by lithotripsy: minimizing short-term shock wave induced renal damage by using antioxidants. Urol Res 2008;36:51-60.
  • 16. Gecit İ, Kavak S, Meral I, Pirinçci N, Güneş M, Demir H, Cengiz N, Ceylan K. Effects of shock waves on oxidative stress, antioxidant enzyme and element levels in kidney of rats. Biol Trace Elem Res 2011;144:1069-1076.
  • 17. Aksoy Y, Malkoc I, Atmaca AF, Aksoy H, Altinkaynak K, Akcay F. The effects of extracorporeal shock wave lithotripsy on antioxidant enzymes in erythrocytes. Cell Biochem Funct. 2006;24:467-469.
  • 18. Carrasco J, Anglada FJ, Campos JP, Muntané J, Requena MJ, Padillo J. The protective role of coenzyme Q10 in renal injury associated with extracorporeal shockwave lithotripsy: a randomised, placebo‐controlled clinical trial Br J Urol int 2014;113:942-950.
  • 19. Clark DL, Connors BA, Evan AP, Willis LR, Handa RK, Gao S. Localization of renal oxidative stress and inflammatory response after lithotripsy. Br J Urol int 2009;103:1562-1568.
  • 20. Serel TA, Ozguner F, Soyupek S. Prevention of shock wave-induced renal oxidative stress by melatonin: an experimental study. Urol Res 2004;32:69- 71.
  • 21. Biri H, Ozturk HS, Buyukkocak S, Kacmaz M, Cimen MY, Unal D, Birey M, Bozkirli I, Durak I.. Antioxidant defense potential of rabbit renal tissues after ESWL: protective effects of antioxidant vitamins. Nephron 1998;79:181- 185.
  • 22. Recker F, Rubben H, Bex A, Constantinides C. Morphological changes following ESWL in the rat kidney. Urol Res 1989;17:229-233.
  • 23. Weber C, Moran M, Braun E, Drach G. Injury of rat renal vessels following extracorporeal shock wave treatment. J Urol 1992;147:476-481.
  • 24. Seguro AC, de Figueiredo LFP, Shimizu MHM. N-acetylcysteine (NAC) protects against acute kidney injury (AKI) following prolonged pneumoperitoneum in the rat. J Surg Res 2012;175:312-315.
  • 25. Shahbazian H, Shayanpour S, Ghorbani A. Evaluation of administration of oral N-acetylcysteine to reduce oxidative stress in chronic hemodialysis patients: A double-blind, randomized, controlled clinical trial. Saudi J Kidney Dis Transpl 2016;27:88-93.
  • 26. Finamor I, Pavanato MA, Pês T, Ourique G, Saccol E, Schiefelbein S, Llesuy S, Partata W. N-acetylcysteine protects the rat kidney against aspartameinduced oxidative stress. Free Radic Biol Med 2014;75:30.
  • 27. Ribeiro G, Roehrs M, Bairros A, Moro A, Charão M, Araújo F, Valentini J, Arbo M, Brucker N, Moresco R, Leal M, Morsch V, Garcia SC. N-acetylcysteine on oxidative damage in diabetic rats. Drug Chem Toxicol 2011;34:467-474.

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