SWL AND RENAL INJURY AND STONE COMMINUTION

  • McAteer, James, (PI)
  • Evan, Andrew (PI)
  • Gao, Sujuan (PI)
  • Khokhlova, Vera (PI)
  • Colonius, T.I.M. (PI)
  • Cleveland, Robin (PI)
  • Bailey, Michael (PI)
  • Fineberg, Naomi S. (PI)
  • Crum, Lawrence (PI)
  • Fineberg, Naomi (PI)
  • Crum, Lawrence (PI)
  • Sturtevant, Bradford (PI)

Project: Research project

Description

Shock wave lithotripsy (SWL) is clearly an effective noninvasive treatment
for a wide variety of upper urinary tract calculi. However, compelling
clinical data now suggest that exposure to shock waves in therapeutic doses
may be associated with 1) acute renal injury in a majority, if not all SWL
patients, 2) at least two chronic effects; a rise in diastolic blood
pressure and a decrease in renal function and 3) renal trauma enhanced by
pre-existing risk factors. Thus, there is a growing, well founded concern
regarding the potential for increased and significant patient morbidity as
SWL continues to gain in popularity. Concern regarding the adverse effects
of SWL is heightened by the prospect that little is known about the
mechanical stresses of shock waves that contribute to stone comminution but
induce extensive cell/tissue injury. To address these concerns, this
Program Project will test a unifying hypothesis which states that, 1) the
mechanical stresses generated by SWL facilitate stone comminution but
induce cellular damage, 2) acute cellular injury in the kidney, transiently
alters renal function, and 3) that pre-existing risk factors predispose the
SWL treated kidney to chronic complications. Four projects are presented.
A whole-animal study (Project 1) will identify and characterize risk
factors thought to lead to acute and chronic impairment of renal
hemodynamics and function, permanent alteration of renal structure and
chronic hypertension. An in vitro study (Project 2) will determine the
role of cavitation in SWL-induced injury to renal tubular epithelial and
vascular endothelial cells. Two biophysical studies (Projects 3 & 4) will
determine how the mechanical stresses (i.e. cavitation, shear, spall)
generated by shock waves contribute to stone comminution but at the same
time cause cellular damage. For the first time, biomechanical
determinations to characterize shock waves will be performed in minipigs
and under in vitro conditions. The new data generated by this Program
Project will provide objectively determined criteria for the safe clinical
use of SWL.
StatusFinished
Effective start/end date5/10/946/30/19

Funding

  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $1,269,974.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $1,241,155.00
  • National Institutes of Health: $1,712,580.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $1,456,468.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $796,255.00
  • National Institutes of Health: $1,481,943.00
  • National Institutes of Health: $1,261,252.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $879,116.00
  • National Institutes of Health
  • National Institutes of Health: $846,136.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $1,247,021.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $1,399,224.00
  • National Institutes of Health: $1,245,010.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $290,672.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $879,116.00
  • National Institutes of Health: $1,462,673.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health: $833,959.00
  • National Institutes of Health
  • National Institutes of Health: $722,934.00
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health
  • National Institutes of Health

Fingerprint

Lithotripsy
Kidney
Wounds and Injuries
Swine
Acoustics
Miniature Swine
Therapeutics

ASJC

  • Medicine(all)