Morphological Changes Induced in the Pig Kidney by Extracorporeal Shock Wave Lithotripsy: Nephron Injury

Youzhi Shao, Bret A. Connors, Andrew Evan, Lynn R. Willis, David A. Lifshitz, James E. Lingeman

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

While shock wave lithotripsy (SWL) is known to cause significant damage to the kidney, little is known about the initial injury to cells along the nephron. In this study, one kidney in each of six juvenile pigs (6-7 weeks old) was treated with 1,000 shock waves (at 24 kV) directed at a lower pole calyx with an unmodified HM-3 lithotripter. Three pigs were utilized as sham-controls. Kidneys were fixed by vascular perfusion immediately after SWL or sham-SWL. Three of the treated kidneys were used to quantitate lesion size. Cortical and medullary samples for light (LM) and transmission electron microscopy (TEM) were taken from the focal zone for the shock waves (F2), the contralateral kidney, and the kidneys of sham-SWL pigs. Because preservation of the tissue occurred within minutes of SWL, the initial injury caused by the shock waves could be separated from secondary changes. No tissue damage was observed in contralateral sham-SWL kidneys, but treated kidneys showed signs of injury, with a lesion of 0.2% ± 0.1% of renal volume. Intraparenchymal hemorrhage and injury to tubules was found at F2 in both the cortex and medulla of SWL-treated kidneys. Tubular injury was always associated with intraparenchymal bleeding, and the range of tissue injury included total destruction of tubules, focal cellular fragmentation, necrosis, cell vacuolization, and membrane blebbing. The initial injury caused by SWL was cellular fragmentation and necrosis. Cellular vacuolization, membrane blebbing, and disorganization of apical brush borders appear to be secondary changes related to hypoxia.

Original languageEnglish
Pages (from-to)979-989
Number of pages11
JournalAnatomical Record - Part A Discoveries in Molecular, Cellular, and Evolutionary Biology
Volume275
Issue number1
StatePublished - Nov 2003

Fingerprint

nephrons
Lithotripsy
Nephrons
Swine
kidneys
Kidney
swine
Wounds and Injuries
Blister
lesions (animal)
hemorrhage
necrosis
Necrosis
Tissue Preservation
Hemorrhage
Microvilli
calyx
microvilli
Transmission Electron Microscopy
blood vessels

Keywords

  • Cell fragmentation
  • Extracorporeal shock wave lithotripsy
  • Lithotripsy injury
  • Nephron injury
  • Pig model
  • Renal morphology

ASJC Scopus subject areas

  • Agricultural and Biological Sciences (miscellaneous)
  • Anatomy

Cite this

Morphological Changes Induced in the Pig Kidney by Extracorporeal Shock Wave Lithotripsy : Nephron Injury. / Shao, Youzhi; Connors, Bret A.; Evan, Andrew; Willis, Lynn R.; Lifshitz, David A.; Lingeman, James E.

In: Anatomical Record - Part A Discoveries in Molecular, Cellular, and Evolutionary Biology, Vol. 275, No. 1, 11.2003, p. 979-989.

Research output: Contribution to journalArticle

Shao, Youzhi ; Connors, Bret A. ; Evan, Andrew ; Willis, Lynn R. ; Lifshitz, David A. ; Lingeman, James E. / Morphological Changes Induced in the Pig Kidney by Extracorporeal Shock Wave Lithotripsy : Nephron Injury. In: Anatomical Record - Part A Discoveries in Molecular, Cellular, and Evolutionary Biology. 2003 ; Vol. 275, No. 1. pp. 979-989.
@article{219dc609c4bb4e248cf10a8241e72da7,
title = "Morphological Changes Induced in the Pig Kidney by Extracorporeal Shock Wave Lithotripsy: Nephron Injury",
abstract = "While shock wave lithotripsy (SWL) is known to cause significant damage to the kidney, little is known about the initial injury to cells along the nephron. In this study, one kidney in each of six juvenile pigs (6-7 weeks old) was treated with 1,000 shock waves (at 24 kV) directed at a lower pole calyx with an unmodified HM-3 lithotripter. Three pigs were utilized as sham-controls. Kidneys were fixed by vascular perfusion immediately after SWL or sham-SWL. Three of the treated kidneys were used to quantitate lesion size. Cortical and medullary samples for light (LM) and transmission electron microscopy (TEM) were taken from the focal zone for the shock waves (F2), the contralateral kidney, and the kidneys of sham-SWL pigs. Because preservation of the tissue occurred within minutes of SWL, the initial injury caused by the shock waves could be separated from secondary changes. No tissue damage was observed in contralateral sham-SWL kidneys, but treated kidneys showed signs of injury, with a lesion of 0.2{\%} ± 0.1{\%} of renal volume. Intraparenchymal hemorrhage and injury to tubules was found at F2 in both the cortex and medulla of SWL-treated kidneys. Tubular injury was always associated with intraparenchymal bleeding, and the range of tissue injury included total destruction of tubules, focal cellular fragmentation, necrosis, cell vacuolization, and membrane blebbing. The initial injury caused by SWL was cellular fragmentation and necrosis. Cellular vacuolization, membrane blebbing, and disorganization of apical brush borders appear to be secondary changes related to hypoxia.",
keywords = "Cell fragmentation, Extracorporeal shock wave lithotripsy, Lithotripsy injury, Nephron injury, Pig model, Renal morphology",
author = "Youzhi Shao and Connors, {Bret A.} and Andrew Evan and Willis, {Lynn R.} and Lifshitz, {David A.} and Lingeman, {James E.}",
year = "2003",
month = "11",
language = "English",
volume = "275",
pages = "979--989",
journal = "Anatomical Record - Part A Discoveries in Molecular, Cellular, and Evolutionary Biology",
issn = "0003-276X",
publisher = "John Wiley and Sons Inc.",
number = "1",

}

TY - JOUR

T1 - Morphological Changes Induced in the Pig Kidney by Extracorporeal Shock Wave Lithotripsy

T2 - Nephron Injury

AU - Shao, Youzhi

AU - Connors, Bret A.

AU - Evan, Andrew

AU - Willis, Lynn R.

AU - Lifshitz, David A.

AU - Lingeman, James E.

PY - 2003/11

Y1 - 2003/11

N2 - While shock wave lithotripsy (SWL) is known to cause significant damage to the kidney, little is known about the initial injury to cells along the nephron. In this study, one kidney in each of six juvenile pigs (6-7 weeks old) was treated with 1,000 shock waves (at 24 kV) directed at a lower pole calyx with an unmodified HM-3 lithotripter. Three pigs were utilized as sham-controls. Kidneys were fixed by vascular perfusion immediately after SWL or sham-SWL. Three of the treated kidneys were used to quantitate lesion size. Cortical and medullary samples for light (LM) and transmission electron microscopy (TEM) were taken from the focal zone for the shock waves (F2), the contralateral kidney, and the kidneys of sham-SWL pigs. Because preservation of the tissue occurred within minutes of SWL, the initial injury caused by the shock waves could be separated from secondary changes. No tissue damage was observed in contralateral sham-SWL kidneys, but treated kidneys showed signs of injury, with a lesion of 0.2% ± 0.1% of renal volume. Intraparenchymal hemorrhage and injury to tubules was found at F2 in both the cortex and medulla of SWL-treated kidneys. Tubular injury was always associated with intraparenchymal bleeding, and the range of tissue injury included total destruction of tubules, focal cellular fragmentation, necrosis, cell vacuolization, and membrane blebbing. The initial injury caused by SWL was cellular fragmentation and necrosis. Cellular vacuolization, membrane blebbing, and disorganization of apical brush borders appear to be secondary changes related to hypoxia.

AB - While shock wave lithotripsy (SWL) is known to cause significant damage to the kidney, little is known about the initial injury to cells along the nephron. In this study, one kidney in each of six juvenile pigs (6-7 weeks old) was treated with 1,000 shock waves (at 24 kV) directed at a lower pole calyx with an unmodified HM-3 lithotripter. Three pigs were utilized as sham-controls. Kidneys were fixed by vascular perfusion immediately after SWL or sham-SWL. Three of the treated kidneys were used to quantitate lesion size. Cortical and medullary samples for light (LM) and transmission electron microscopy (TEM) were taken from the focal zone for the shock waves (F2), the contralateral kidney, and the kidneys of sham-SWL pigs. Because preservation of the tissue occurred within minutes of SWL, the initial injury caused by the shock waves could be separated from secondary changes. No tissue damage was observed in contralateral sham-SWL kidneys, but treated kidneys showed signs of injury, with a lesion of 0.2% ± 0.1% of renal volume. Intraparenchymal hemorrhage and injury to tubules was found at F2 in both the cortex and medulla of SWL-treated kidneys. Tubular injury was always associated with intraparenchymal bleeding, and the range of tissue injury included total destruction of tubules, focal cellular fragmentation, necrosis, cell vacuolization, and membrane blebbing. The initial injury caused by SWL was cellular fragmentation and necrosis. Cellular vacuolization, membrane blebbing, and disorganization of apical brush borders appear to be secondary changes related to hypoxia.

KW - Cell fragmentation

KW - Extracorporeal shock wave lithotripsy

KW - Lithotripsy injury

KW - Nephron injury

KW - Pig model

KW - Renal morphology

UR - http://www.scopus.com/inward/record.url?scp=0242385391&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0242385391&partnerID=8YFLogxK

M3 - Article

C2 - 14533172

AN - SCOPUS:0242385391

VL - 275

SP - 979

EP - 989

JO - Anatomical Record - Part A Discoveries in Molecular, Cellular, and Evolutionary Biology

JF - Anatomical Record - Part A Discoveries in Molecular, Cellular, and Evolutionary Biology

SN - 0003-276X

IS - 1

ER -