A pilot study evaluating changes to haematological and biochemical tests after Flexible Ureterorenoscopy for the treatment of kidney stones

• Published in: PloS one 2017-07, Vol.12 (7), p.e0179599-e0179599
• Main Authors: Moyes, Alyson Jayne, Lamb, Rebecca May, Ella-Tongwiis, Peter, Pushkaran, Anish, Ahmed, Issam, Shergill, Iqbal, Hughes, Stephen Fôn
• Format: Article
• Language: English
• Subjects: Acute phase proteins; Adult; Aged; Aged, 80 and over; Albumin; Alkaline phosphatase; Alkaline Phosphatase - blood; Bilirubin; Biochemical tests; Biochemistry; Biology and Life Sciences; Blood; Blood Cell Count; Blood cells; Blood tests; C-reactive protein; C-Reactive Protein - metabolism; Care and treatment; Complications; Creatinine; Eosinophils; Erythrocyte Indices; Erythrocytes; Female; Fibrin; Fibrinogen; Fibrinogen - metabolism; Globulins; Heart surgery; Hematology; Hemoglobin; Hospitals; Humans; Kidney - pathology; Kidney - surgery; Kidney Calculi - blood; Kidney Calculi - pathology; Kidney Calculi - surgery; Kidney stones; Kidneys; Leukocytes; Leukocytes (basophilic); Leukocytes (eosinophilic); Leukocytes (neutrophilic); Limiting factors; Lithotripsy; Lithotripsy, Laser - instrumentation; Lithotripsy, Laser - methods; Lymphocytes; Male; Medical wastes; Medicine and Health Sciences; Middle Aged; Nephrolithiasis; Patients; Phosphatases; Pilot Projects; Potassium; Sepsis; Serum Albumin - metabolism; Sodium; Thromboplastin; Ureteroscopy - instrumentation; Ureteroscopy - methods; Urology; Von Willebrand factor; von Willebrand Factor - metabolism
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0179599

Currently there is limited research documenting the changes in blood parameters, following Flexible Ureterorenoscopy. This study aims to determine whether there are any changes in haematology and biochemistry parameters, following Flexible Ureterorenoscopy for the treatment of kidney stones. 40 consecutive patients aged between 27-87 years (median 49 years) undergoing Flexible Ureterorenoscopy for the treatment of kidney stones were recruited (26 male, 14 female). Blood samples were collected from each patient at four time points: baseline (pre-operatively) followed by 30 minutes, 120 minutes and 240 minutes post-operatively. On these samples, routine haematological and biochemistry tests were carried out. In addition to the assessment of clinical parameters prospectively from the medical notes. There was a significant decrease observed following Flexible Ureterorenoscopy in the following parameters: lymphocytes (p = 0.007), eosinophils (p = 0.001), basophils (p = 0.001), haemoglobin (p = 0.002), red blood cells (p = 0.001), platelet count (p = 0.001), fibrinogen concentration (p = 0.001), von Willebrand factor (p = 0.046), C reactive protein (p = 0.01), total protein (p = 0.001), albumin (p = 0.001), globulin (p = 0.001) and alkaline phosphatase (p = 0.001). In addition, there was a significant increase observed in the following parameters: white blood cells (p = 0.001), neutrophils (p = 0.001), activated partial thromboplastin time (p = 0.001), total bilirubin (p = 0.012), creatinine (p = 0.008), sodium (p = 0.002) and potassium (p = 0.001). Limiting factors for this study were the sample size, and restriction on the recruitment time points. Significant changes were noted to occur in haematology and biochemistry parameters following Flexible Ureterorenoscopy. Some of the data presented in this study may represent the 'normal' post-operative response following FURS, as no major complications occurred, in the majority of our patients. This data on the 'normal response' will need to be validated but may ultimately aid clinicians in distinguishing patients at risk of complications, if reproduced in larger multi-centre studies.