Effect of Extracorporeal Shockwave Lithotripsy for Urolithiasis on Concentrations of Creatine Kinase Isozymes in Patient Serum and Urine

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Abstract
To determine whether extracorporeal Shockwave lithotripsy (ESWL) for urolithiasis causes renal injury, we immunoassayed creatine kinase isozymes (CK-B and CK-M) in serum and urine from patients with renal stone (n = 21) and ureteral stone (n = 18) before and after (0, 2, and 24 h) ESWL. CK-B is generally present in renal tissue at relatively high concentrations, whereas CK-M is found at low concentrations. CK-B and CK-M levels were enhanced both in the serum and urine samples after ESWL in both groups of patients but CK-B levels return to almost normal very rapidly. Because CK-M, which is mainly localized in muscle tissue, also increased in both groups, the increased CK-B in serum after ESWL might be derived not only from kidney but also from muscle tissues which also contain a significant level of CK-B. These results suggest that significant tissue injury, including kidney and muscles, might be caused by ESWL treatment for urolithiasis but there is no long-term renal adverse effect, and that creatine kinase isozymes in serum and urine might be useful markers of tissue injury by such treatment.

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