Renal disease potentiates the injury caused by SWL

Andrew P. Evan, Bret A. Connors, Debra J. Pennington, Philip M. Blomgren, James E. Lingeman, Naomi S. Fineberg, Lynn R. Willis

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17 Scopus citations

Abstract

Purpose: The present study tested the hypothesis that renal disease potentiates the structural/functional changes induced by a clinical dose of shockwaves. Materials and Methods: Experimental pyelonephritis was induced in 6- to 8-week-old pigs before treatment with 2000 shocks at 24 kV. These pigs were divided into two groups according to whether they were infected with a highly virulent (Group 1) or less virulent (Group 2) inoculation of E. coli. All animals were imaged by MR prior to SWL as a means of documenting the extent of pyelonephritis and immediately after SWL to examine the lesion produced by the shockwaves. The glomerular filtration rate (GFR), renal plasma flow (RPF) and para-aminohippurate (PAH) extraction were determined bilaterally on day 30 (Group 1)or day 80 (Group 2). Results: In group 2, urine flow and sodium excretion were reduced by 50% from baseline in the shocked kidneys at both 1 and 4 hours post-SWL. A sustained reduction in RPF through 4 hours post-SWL was noted in the shocked kidneys in Group 1, but RPF was significantly reduced only at the 1-hour determination in Group 2. Large, consistent reductions in GFR were evident at 1 and 4 hours post-SWL in shocked and unshocked kidneys of Group 2 and in the shocked kidneys of Group 1. No significant changes were noted in PAH extraction. Conclusion: Acute pyelonephritis exaggerated the effect of a clinical dose of shockwaves on renal hemodynamics. This effect suggests that renal disease may be risk factor for SWL-induced injury.

Original languageEnglish (US)
Pages (from-to)619-628
Number of pages10
JournalJournal of Endourology
Volume13
Issue number9
DOIs
StatePublished - Jan 1 1999

ASJC Scopus subject areas

  • Urology

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    Evan, A. P., Connors, B. A., Pennington, D. J., Blomgren, P. M., Lingeman, J. E., Fineberg, N. S., & Willis, L. R. (1999). Renal disease potentiates the injury caused by SWL. Journal of Endourology, 13(9), 619-628. https://doi.org/10.1089/end.1999.13.619