Diagnosis of stone-related pyelonephritis activity by monitoring urine electrochemical properties and dynamics of urinary inflammatory mediator IL–8

   Introduction. Percutaneous nephrolithotripsy is an important minimally invasive method for treating kidney stones. It is appreciated for its low injury rate and quick recovery. However, one of the most serious complications that can occur after this procedure is calculous pyelonephritis. The timing and safe removal of nephrostomy drainage in the postoperative period remain a significant concern for urologists.

   Objective. To determine the possibility of using joulemetry and monitoring urinary IL-8 levels to diagnose stone-related pyelonephritis activity following percutaneous nephrolithotripsy.

   Materials & methods. The study involved 220 patients with kidney stones who had percutaneous nephrolithotripsy at the SSMU Urology Clinic in 2022 – 2023. The patients were aged between 25 and 65 years, including 135 women (61.3 %) and 85 men (38.7 %). The control group consisted of 30 healthy people aged 24 to 67 years: 18 women (60 %) and 12 men (40 %). After surgery, electrochemical urine examination using the joulemetric method according to a patented technique was performed for patients with stone-related pyelonephritis and for those in the control group.

   Results. When analysing the urine IL-8 level, leukocyturia in the urine test, and the current operation based on joulemetry data, we observe a significant increase in all studied parameters on day 1 compared to the control group (p > 0.05). The values of the studied indicators reach their peak range by day 3 and return to those of the control group by day 5. At the same time, even if there is no leukocyturia on day three, the values of the current parameter and the urine IL-8 level remain elevated in most patients.

   Conclusion. Joulemetry helps to diagnose the activity of stone-related pyelonephritis in the postoperative period. This is confirmed by general clinical examinations and the determination of urine IL-8 as a marker of inflammation. Using this method allows optimising the timing of drainage removal after surgery.

1. Ghani KR, Andonian S, Bultitude M, Desai M, Giusti G, Okhunov Z, Preminger GM, de la Rosette J. Percutaneous Nephrolithotomy: Update, Trends, and Future Directions. Eur Urol. 2016;70(2):382-396. DOI: 10.1016/j.eururo.2016.01.047

2. Wu WJ, Okeke Z. Current clinical scoring systems of percutaneous nephrolithotomy outcomes. Nat Rev Urol. 2017;14(8):459-469. DOI: 10.1038/nrurol.2017.71

3. Khotko A.I., Khotko D.N., Popkov V.M., Tarasenk A.I. Optimizing the lithotripsy timing after drainage of the upper urinary tract in patients with urolithiasis and obstructive uropathy. Urology Herald. 2021;9(3):62-69. (In Russian). DOI: 10.21886/2308-6424-2021-9-3-62-69

4. Grigor’ev N.A., Semenyakin I.V., Malhasyan V.A., Gadzhiev N.K. Urolithiasis. Urologiia. 2016;(S2):37-70. (In Russian). eLIBRARY ID: 26006186 EDN: VXCKXF

5. Abbott JE, Deem SG, Mosley N, Tan G, Kumar N, Davalos JG. Are we fearful of tubeless percutaneous nephrolithotomy? Assessing the need for tube drainage following percutaneous nephrolithotomy. Urol Ann. 2016;8(1):70-75. DOI: 10.4103/0974-7796.162214

6. Lee JY, Kim KH, Kim MD, Chung DY, Cho KS. Intraoperative patient selection for tubeless percutaneous nephrolithotomy. Int Surg. 2014;99(5):662-668. DOI: 10.9738/INTSURG-D-13-00120.1

7. Crook TJ, Lockyer CR, Keoghane SR, Walmsley BH. Totally tubeless percutaneous nephrolithotomy. J Endourol. 2008;22(2):267-271. DOI: 10.1089/end.2006.0034

8. Moosanejad N, Firouzian A, Hashemi SA, Bahari M, Fazli M. Comparison of totally tubeless percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for kidney stones: a randomized, clinical trial. Braz J Med Biol Res. 2016;49(4):e4878. DOI: 10.1590/1414-431X20154878

9. Veser J, Fajkovic H, Seitz C. Tubeless percutaneous nephrolithotomy: evaluation of minimal invasive exit strategies after percutaneous stone treatment. Curr Opin Urol. 2020;30(5):679-683. DOI: 10.1097/MOU.0000000000000802

10. Zilberman DE, Lipkin ME, de la Rosette JJ, Ferrandino MN, Mamoulakis C, Laguna MP, Preminger GM. Tubeless percutaneous nephrolithotomy -- the new standard of care? J Urol. 2010;184(4):1261-1266. DOI: 10.1016/j.juro.2010.06.020

11. Patent RF na izobretenie № 2 812 228 C1, MPK G01N 33/48 (2006.01) G01N 33/487 (2006.01) G01N 33/493 (2006.01) Hot’ko D.N., Hot’ko A.I., Gerashhenko S.I., Popkov V.M., Tarasenko A.I. Sposob jelektrohimicheskogo opredelenija nalichija vospalitel’nogo processa pri kal’kuleznom pielonefrite. Available at November 11, 2024. (In Russian). URL: https://www1.fips.ru/iiss/document.xhtml?faces-redirect=true&id=9b31a4bd692c8ee88aecd31fded60993

12. Teh KY, Tham TM. Predictors of post-percutaneous nephrolithotomy sepsis: The Northern Malaysian experience. Urol Ann. 2021;13(2):156-162. DOI: 10.4103/UA.UA_28_20

13. Al Rushood M, Al-Eisa A, Al-Attiyah R. Serum and Urine Interleukin-6 and Interleukin-8 Levels Do Not Differentiate Acute Pyelonephritis from Lower Urinary Tract Infections in Children. J Inflamm Res. 2020;13:789-797. DOI: 10.2147/JIR.S275570

14. Krzemień G, Szmigielska A, Turczyn A, Pańczyk-Tomaszewska M. Urine interleukin-6, interleukin-8 and transforming growth factor β1 in infants with urinary tract infection and asymptomatic bacteriuria. Cent Eur J Immunol. 2016;41(3):260-267. DOI: 10.5114/ceji.2016.63125