Leucine aminopeptidase enzymuria: quantification of renal tubular damage following extracorporeal shock wave lithotripsy.

To evaluate the extent of renal parenchymal injury following high energy shock wave (HESW) application we measured the urine levels of two renal tubular brush border enzymes: leucine aminopeptidase (LAP) and gamma-glutamyltranspeptidase (GGT) the day before, 24 hours and 7 days after extracorporeal shock wave lithotripsy (ESWL) in 23 patients. All patients had caliceal stones and were treated with a Dornier MPL 9000 lithotriptor under sedoanalgesia. Creatinine concentration of each sample together with total shock wave effect (TSWE) values were also assessed and comparatively evaluated with enzymuria levels. Our results indicated a statistically significant rise in urinary excretion of both enzymes after 24 hours following lithotripsy (p < 0.05). All these values returned to normal limits within 7 days after ESWL (p > 0.05). Transient tubular damage due to HESW was found to be related to TSWE values assessed in our group.