Urinary Markers for Unilateral Kidney Obstruction
Urinary Markers for Unilateral Kidney Obstruction
Renal colic is usually caused from an obstructing stone along the ureter. Some of the
 patients present with a high level of creatinin in the blood, even though there is a normal
 functioning contralateral kidney. Furthermore creatinin is not an ideal marker for renal
 function during acute changes.

 Several works have shown that modern urinary markers such as NGAL (neutrophil
 gelatinase-associated lipocalin), KIM-1 (Kidney Injury Molecule-1) and others rise earlier
 and are much more sensitive for kidney insult. There is a lack of research on their role in
 acute kidney obstruction
The study population will include 100 men and women that will be recruited during the
 upcoming year, with a follow up of up to 3 months.

 The study population will be divided into 2 groups:

 1. The stone group: about 80 patients, aged 18-65, with normal creatinine for the past year
 that presented in our ER because of renal colic, and their imaging shows a ureteral
 stone.

 2. The non-stone group: about 20 patients that present in our department for elective
 surgery not related to stones or bladder outlet obstruction.

 The stone group:

 ---------------- In the ER the patients will be examined, undergo blood and urine workup and
 imaging as usual. If they are applicable according to our inclusion and exclusion criteria
 and admitted and they will be included in our stone group. After signing an informed consent,
 either as patients with a ureteral stone and normal creatinine or as patients with a ureteral
 stone and an abnormal creatinine, Their urine sample will be sent for the urinary markers:
 NGAL, KIM-1, ENdothelin and Cystatin C.

 At this point it will be decided to admit or discharge them according to their clinical
 imaging and laboratory findings, as acceptable. The admitted patients will be followed for 48
 with additional blood and urine tests.

 The admitted patients that will undergo renal drainage will be a specific subgroup in which a
 selective urine test will be taken from the drained kidney

 The non stone group:

 -------------------- These are our control group from which we will take a single blood and
 urine test before their elective surgery.
Inclusion Criteria for stone group:

 -  no known kidney disease

 -  turned to the ER due to renal colic

 -  imaging demonstrates a partially or totally obstructing ureteral stone

 Inclusion Criteria for non stone group:

 -  turned to the urology department for ambulatory surgery: hydrocelectomy,
 varicocelectomy, stress incontinence repair,circumcision,cystoscopy

 Exclusion Criteria:

 -  patients with stones in the contralateral ureter

 -  patients who underwent renal surgery

 -  patients who took NSAID's (nonsteroidal antiinflammatory drugs) in the past week
 before presentation

 -  patients woth anatomical defects in the kidneys