Assessing renal damage caused by new high power lasers during ureteroscopic laser lithotripsy: a randomized trial

You have accessJournal of UrologyCME1 Apr 2023MP23-10 ASSESSING RENAL DAMAGE CAUSED BY NEW HIGH POWER LASERS DURING URETEROSCOPIC LASER LITHOTRIPSY: A RANDOMIZED TRIAL Alan Yaghoubian, Roman Shimonov, Blair Gallante, Raymond Khargi, Dara Lundon, Johnathan Khusid, Manishkumar Patel, Kai Nie, Hui Xie, Jingjing Xi, Nicholas Zaki, Seunghee Kim Schulze, William Atallah, Natasha Kyprianou, and Mantu Gupta Alan YaghoubianAlan Yaghoubian More articles by this author , Roman ShimonovRoman Shimonov More articles by this author , Blair GallanteBlair Gallante More articles by this author , Raymond KhargiRaymond Khargi More articles by this author , Dara LundonDara Lundon More articles by this author , Johnathan KhusidJohnathan Khusid More articles by this author , Manishkumar PatelManishkumar Patel More articles by this author , Kai NieKai Nie More articles by this author , Hui XieHui Xie More articles by this author , Jingjing XiJingjing Xi More articles by this author , Nicholas ZakiNicholas Zaki More articles by this author , Seunghee Kim SchulzeSeunghee Kim Schulze More articles by this author , William AtallahWilliam Atallah More articles by this author , Natasha KyprianouNatasha Kyprianou More articles by this author , and Mantu GuptaMantu Gupta More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003248.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The high power Holmium (Ho:YAG) and thulium fibre lasers (TFL) generate enough heat in surrounding fluid to cause renal cellular damage, yet the degree to which this occurs has yet to be quantified. We aim to establish a relative safety profile of the TFL and Ho:YAG by quantifying the degree of renal damage during ureteroscopic laser lithotripsy (URSLL). METHODS: This is an ongoing randomized controlled trial of patients undergoing URSLL with unilateral non-obstructing renal stones. Patients are randomized to undergo URSLL with either the TFL or Ho:YAG laser. Each patient’s urine is collected immediately pre-op (V1), 1 hour post-op (V2), and 10 days post-op (POD#10, V3). Samples are analyzed by enzyme-linked immunosorbent assay (ELISA) for the following biomarkers: Kidney injury molecule-1 (KIM-1), Neutrophil gelatinase-associated lipocalin (NGAL), and β2-microglobulin (β2M), then normalized to urine creatinine. Primary outcome is degree of renal injury based on urinary biomarker changes. RESULTS: To date 26 patients (16 TFL, 10 Ho:YAG) have been included. Baseline patient and stone characteristics were similar. Relative to controls, both lasers caused pronounced rises in biomarkers in the immediate postoperative period with a trend back towards baseline by postoperative day 10 (Figure 1). However, the Ho:YAG laser caused a persistent rise in NGAL at 10 days. In terms of percent change from baseline, there were no significant differences between cohorts for any of the biomarkers (Figure 2). CONCLUSIONS: Our pilot analysis suggests that there is notable laser-induced renal parenchymal damage for both TFL and Ho:YAG. The renal damage safety profile appears similar for both lasers. Source of Funding: This work was funded in part by a grant from the New York Academy of Medicine © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e309 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alan Yaghoubian More articles by this author Roman Shimonov More articles by this author Blair Gallante More articles by this author Raymond Khargi More articles by this author Dara Lundon More articles by this author Johnathan Khusid More articles by this author Manishkumar Patel More articles by this author Kai Nie More articles by this author Hui Xie More articles by this author Jingjing Xi More articles by this author Nicholas Zaki More articles by this author Seunghee Kim Schulze More articles by this author William Atallah More articles by this author Natasha Kyprianou More articles by this author Mantu Gupta More articles by this author Expand All Advertisement PDF downloadLoading ...