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A Pilot Study to Evaluate Haemostatic Function, following Shock Wave Lithotripsy (SWL) for the Treatment of Solitary Kidney Stones

Hughes, Stephen F.
; 
Thomas-Wright, Samantha J.
; 
Banwell, Joseph
; 
Williams, Rachel
; 
Moyes, Alyson J.
; 
Mushtaq, Sohail
; 
Abdulmajed, Mohamed
; 
Shergill, Iqbal
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Other Contributors
Affiliation
University of Chester; BCUHB Wrexham Maelor Hospital
EPub Date
Publication Date
2015-05-04
Submitted Date
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Biological Sciences
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Abstract
Purpose: The number of patients undergoing shock wave lithotripsy (SWL) in the UK for solitary unilateral kidney stones is increasing annually. The development of postoperative complications such as haematuria and sepsis following SWL is likely to increase. Comparing a range of biological markers with the aim of monitoring or predicting postoperative complications following SWL has not been extensively researched. The main purpose of this pilot-study was to test the hypothesis that SWL results in changes to haemostatic function. Subsequently, this pilot-study would form a sound basis to undertake future investigations involving larger cohorts. Methods: Twelve patients undergoing SWL for solitary unilateral kidney stones were recruited. From patients (8 male and 4 females) aged between 31–72 years (median—43 years), venous blood samples were collected pre-operatively (baseline), at 30, 120 and 240 minutes postoperatively. Specific haemostatic biomarkers [platelet counts, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, D-dimer, von Willebrand Factor (vWF), sE-selectin and plasma viscosity (PV)] were measured. Results: Platelet counts and fibrinogen concentration were significantly decreased following SWL (p = 0.027 and p = 0.014 respectively), while D-dimer and vWF levels significantly increased following SWL (p = 0.019 and p = 0.001 respectively). PT, APTT, sE-selectin and PV parameters were not significantly changed following SWL (p>0.05). Conclusions: Changes to specific biomarkers such as plasma fibrinogen and vWF suggest that these represent a more clinically relevant assessment of the extent of haemostatic involvement following SWL. Analysis of such markers, in the future, may potentially provide valuable data on “normal” response after lithotripsy, and could be expanded to identify or predict those patients at risk of coagulopathy following SWL. The validation and reliability will be assessed through the assessment of larger cohorts.
Citation
Hughes, S. F., Thomas-Wright, S. J., Banwell, J., Williams, R., Moyes A. J., et. al. (2015). A Pilot Study to Evaluate Haemostatic Function, following Shock Wave Lithotripsy (SWL) for the Treatment of Solitary Kidney Stones. PLoS ONE, 10(5): e0125840. DOI: 10.1371/journal.pone.0125840
Publisher
Public Library of Science
Journal
PLoS ONE
Research Unit
URI
http://hdl.handle.net/10034/604108
DOI
10.1371/journal.pone.0125840
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PubMed Central ID
Type
Article
Language
en
Description
Original Research Article
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ISSN
EISSN
1932-6203
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The authors would like to acknowledge the Institute of Biomedical Science (IBMS) and the University of Chester (Research & Knowledge Transfer Office) for their financial support.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0125840