Böbrek taşı hastalarda ESWL’ ye bağlı renal hasar üzerine nar suyunun önleyici etkisi

Abstract

Amaç: Böbrek taşı tanısı nedeni ile ekstrakorporeal şok dalga litotripsi (ESWL) tedavisi uygulanan hastalarda, ESWL’nin neden olduğu oksidatif stresin yarattığı böbrek hasarının; nar suyunun (NS) antioksidan etkisiyle tedaviye bağlı böbrek hasarına karşı koruyucu etkisi olup olmadığını göstermeyi amaçladık.
Gereç ve Yöntemler: Böbrek taşı nedeniyle ESWL uygulanacak 90 hasta çalışmaya dahil edildi ve 30 kişiden oluşan 3 gruba ayrıldı. Grup 1’deki (kontrol grubu) hastalara sadece ESWL tedavisi uygulandı. Grup 2’deki (çalışma grubu) hastalara ESWL’den 2 gün önce 30 ml/kg/gün hazırlanan nar suyu karışımı 2 gün oral alınması önerildi. Grup 3’teki (plasebo grubu) hastalara ESWL’den 2 gün önce 30 mg/kg/gün su oral alınması önerildi. Hastalara 18-24 kV aralığında 2000-2500 atış yapıldı. Oksidatif stres, DNA lezyonunu gösteren lipid peroksidasyonun belirteçleri ve ESWL’den sonra tübüler hasar göstermek amacı ile her üç gruptaki hastalardan ESWL’den 3 gün önce ve hemen sonra 24 saatlik idrar toplandı ve spot idrar numunesi alındı.
Bulgular: Grup 1’de tedavi sonrası 8-Hydroxy deoxyguanosine (8-OHdG) düzeylerinde ortalama 52,39± 10,49 düzeyinde artış gözlendi (p<0,01). Grup 2’de tedavi sonrası 8-OHdG düzeylerinde ortalama 13,16±7,71 düzeyinde artış gözlendi (p<0,01).
Grup 1’de tedavi sonrası N-acetyl-beta-D-glucosaminidase (NAG) düzeylerinde görülen ortalama l9,20±5,21 düzeyinde artış gözlendi (p<0,01).Grup 2’de tedavi sonrası NAG düzeylerinde ortalama 3,44±5,21 düzeyinde artış gözlendi(p<0,01).
Sonuç: Çalışmamızda NS’nin ESWL’ye bağlı böbrek hasarı üzerine koruyucu etkisi olduğunu gösterdik.

Keywords

• Antioksidan
• böbrek taşı
• taş kırma
• nar suyu

Preventive effect of pomegranate juice on ESWL-related renal damage in patients with kidney stones

Abstract

Objective: We aimed to show whether the antioxidant properties of pomegranate juice (PJ) show a protective effect against renal damage associated with oxidative stress caused by Extracorporeal Shock Wave Lithotripsy (ESWL) in patients who have undergone ESWL for kidney stones. 
Material and Methods: Ninety patients who were to undergo ESWL for kidney stones were included in the study and were divided into 3 groups with 30 patients each ESWL. Group 1 (control group) patients received only ESWL treatment. Group 2 (study group) patients were recommended to take 30 ml/kg/day pomegranate juice mixture orally for 2 days before ESWL. Group 3 (placebo group) patients were recommended to take 30 mg/kg/day water orally for 2 days before ESWL. All ESWL-treated patients received 2000 to 2500 shock waves at 18 to 24 in order to measure lipid peroxidation markers showing the DNA lesion associated with oxidative stress and to show tubular damage after ESWL, 
Results: There was a statistically significant mean increase of 52.39± 10.49 in 8-Hydroxy deoxyguanosine (8-OHdG) levels after treatment compared to pre-treatment levels in Group 1 (p<0.01). There was a statistically significant mean increase of 13.16±7.71 and 33.24±12.82 in Groups 2 and 3, respectively (p<0.01; p<0.01, respectively)
There was a statistically significant mean increase of 19.20±5.21 in N-acetyl-beta-D-glucosaminidase (NAG) levels after treatment compared to pre-treatment levels in Group 1 (p<0.01). There was a statistically significant mean increase of 3.44±5.21 and 13.07±5.50 in Groups 2 and 3, respectively (p<0.01; p<0.01, respectively).
Conclusion: Our study concluded that pomegranate juice (PJ) has protective effects against ESWL-related renal damage.

Keywords

• Antioxidant
• Kidney stones
• Lithotripsy
• Pomegranate Juice.

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