The EFFECTIVENESS OF LOSARTAN IN EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) INDUCED NEPHRON INJURY
Keywords:
Urolithiasis, Lithotripsy, Losartan, ESWL, Complications, Kidney StoneAbstract
ABSTRACT:
OBJECTIVE:
To Compare the Reno-protective effectiveness of Multi vitamins as antioxidants versus Losartan in reducing Albuminuria in extra corporeal shock wave lithotripsy induced renal injury.
METHODS:
It is a randomized control trail conducted in Department of Urology "Team C" at Institute of Kidney Diseases Peshawar from June 2018 till December 2019. We included patients of less than 20 mm renal stone amenable with ESWL. We excluded patients with Diabetes Mellitus, Hypertension, congenital renal anomalies, marked hydronephrosis and patients with pre-procedure albuminuria. The total sample of 180 was equally divided in to two groups by lottery method. Group A comprising of 90 patients (Control) who were given multivitamin (Zinc, Selenium, Vitamin A& C) 2hours before and 1 tablet every 8 hours after ESWL for 1 week. Group B comprising of 90 patients were given Tab Losartan 50 mg 2 hour before ESWL and 1 OD after ESWL for 1 week. The albuminuria was assessed before ESWL and at 2-4 hours and 1 week after standard ESWL of 3000 shocks. All the data was recorded on structured proforma and was analyzed on SPSS.
RESULTS:
All the demographic variables like age, gender. Laterality, BMI in both of group were similar with no significant difference, the albuminuria before ESWL in Group A and Group B was 13.9 mg/dl and 14.1 mg/dl. The albuminuria after 2-4 hours of ESWL in group A was 547 mg/dl and was 581mg/dl in Group B (P 0.098). The albuminuria after 1 week of ESWL in Group A was 59 mg/dl in Group B versus 41 mg/dl in Group B (p< 0.001)
Conclusion: Losartan is superior to the anti oxidants as Reno protective against ESWL induced renal injury by significantly decreasing albuminuria.
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