Assessing the Effects of Using a Ureteral Access Sheath on Kidney Injury in Retrograde Intrarenal Surgery with KIM-1 and NGAL Biomarkers in Urine: A Prospective Cohort Study

What's known on the subject? and What does the study add?The pressure effect of the irrigation fluid used during retrograde intrarenal surgery (RIRS) and mechanical occlusion of the f-URS may have a negative effect on the kidney by increasing intrapelvic pressure.Even though its use is not mandatory in routine practices, ureteral access sheath (UAS) is generally preferred to be used by urologists considering its advantages.The use of UAS ensures removal of stones, ease of access of f-URS and low intra-renal pressure.Kidney injury molecule-1 (KIM-1) and neutrophil gelatinase associated lipocalin (NGAL) have been the leading tubule damage markers analysed in urine levels in recent years to show acute kidney injury.The use of UAS in RIRS applications was effective in preventing kidney damage and did not cause any complications.We demonstrated the development of kidney damage with KIM-1 and NGAL biomarkers measured in urine.It was revealed that more kidney damage developed in the group not using UAS compared to the group in which UAS was used, especially in the 24 th postoperative hour.