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    Evaluation of the effect of 9.5/11.5-fr ureteral access sheath use on acute kidney injury with the myo-inositol oxygenase biomarker in patients undergoing retrograde intrarenal surgery: a prospective, randomized, and controlled study
    (Taylor & Francis Ltd, 2024) Turan, Abdullah; Hirik, Erkan; Erdogan, Abdullah; Altun, Abdulsemet; Mertoglu, Cuma; Sam, Emre; Atar, Muhittin
    IntroductionWe aimed to investigate whether a low intrarenal pressure provided by ureteral access sheath (UAS) use had a positive effect on the prevention of acute kidney injury through the evaluation of the myo-inositol oxygenase (MIOX).Material and methodsThe patients were divided into two groups according to whether a 9.5/11.5-Fr UAS was used during retrograde intrarenal surgery (RIRS): UAS group and non-UAS group. RIRS was performed under gravity irrigation and manual pumping was not used. For the measurement of MIOX, 5 cc blood samples were taken from the patients preoperatively and four hours postoperatively.ResultsOperation time and hospital stay were significantly longer in the UAS group. The mean preoperative and postoperative MIOX values were 0.77 +/- 0.36 ng/ml and 0.74 +/- 0.38 ng/ml, respectively, in the UAS group, and 0.74 +/- 0.31 ng/ml and 0.83 +/- 0.40 ng/ml, respectively, in the non-UAS group. The mean MIOX change was -0.29 +/- 0.36 in the UAS group and 0.08 +/- 0.44 in the non-UAS group, indicating no significant difference between the groups.ConclusionEven if UAS is not used, significant acute kidney injury is not observed under gravity irrigation and therefore, if we avoid manual pumping, the intrarenal pressure remains low, thus potentially rendering the use of 9,5/11,5-Fr UAS unnecessary.