We read the article by Carrasco et al.  with interest. The study is worth attention as it relates to short-term CoQ10 use to prevent renal damage caused by SWL. However, some conflicting points and omissions occur. In addition, it would have been more ethically appropriate to conduct an animal study.
There are studies on the use and effectiveness of CoQ10 in renal diseases. Ishikawa et al.,  Gokbel et al.,  Sourris et al.,  Sato et al.  and El-Sheikh et al.  state that CoQ10 effectively recovers renal functions and that it can be a treatment option for renal diseases.
Carrasco et al.  specifies that SWL was performed at a frequency of 60 waves/minute. Although the related mechanism of action has not been fully explained so far, completing the session at a low frequency is known to cause less damage to the kidney . It could have been possible to apply treatment at various frequencies to identify the efficacy on CoQ10 based on the levels of damage.
It is understood that CoQ10 was used in daily doses of 200 mg over 2 weeks. However, in my opinion, this is a short period of time to determine the effectiveness of the treatment. The ideal blood level of CoQ10 should be more than 5.3 µg/ml , so it would have been more appropriate if the term of the study was between 4 to 6 weeks.
There are numerous studies showing that SWL causes oxidative stress. Yilmaz et al.  recently reported that SWL affects the oxidant/antioxidant balance in favour of oxidants. The findings in the study by Carrasco et al.  seem to be inconsistent with information showing the relationship between SWL and oxidative stress.
Erdal Yilmaz and Ercan Yuvanc
University of Kirikkale, Faculty of Medicine, Department of Urology, Kirikkale, Turkey
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