Shockwave lithotripsy: Dose-related effects on renal structure, hemodynamics, and tubular function

Lynn R. Willis, Andrew Evan, Bret A. Connors, Youzhi Shao, Philip M. Blomgren, J. Howard Pratt, Naomi S. Fineberg, James E. Lingeman

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Background and Purpose: Shockwave lithotripsy (SWL) predictably damages renal tissue and transiently reduces function in both kidneys. This study characterized the effects on renal function of a supraclinical dose of shockwaves (SWs) (8000) in porcine kidneys and tested the hypothesis that such excessive treatment would intensify and prolong the resulting renal impairment. Materials and Methods: Pigs aged 6 to 7 weeks were anesthetized and assigned to one of three groups. Groups 1 (N = 8) and 2 (N = 6) each received 8000 SWs at 24 kV (Dornier HM3) to the lower-pole calix of one kidney. Group 3 (7 pigs) received sham treatment. Renal function was monitored for the first 4 hours after SW treatment in Group 1 and for 24 hours in Group 2. Plasma renin activity was measured in Groups 2 and 3. Results: The renal lesions produced by 8000 SWs comprised 13.8% ± 1.4% of the renal mass. In the 4-hour protocol, this injury was associated with marked reduction of the glomerular filtration rate (GFR), renal plasma flow (RPF), and urinary sodium excretion in both kidneys, although fractional sodium excretion was reduced only in the shocked kidneys. In the 24-hour protocol, GFR and RPF remained below baseline in shocked kidneys at 24 hours. Evidence of progressive ischemic injury was noted in shocked tissue at 24 hours after SW treatment. Conclusions: These findings support the hypothesis that the severity of the renal injury caused by SWL is related to the number of SWs administered and demonstrate the connection in this relation between renal structure and function.

Original languageEnglish
Pages (from-to)90-101
Number of pages12
JournalJournal of Endourology
Volume19
Issue number1
DOIs
StatePublished - Jan 2005

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Lithotripsy
Hemodynamics
Kidney
Renal Plasma Flow
Swine
Glomerular Filtration Rate
Kidney Calices
Wounds and Injuries
Sodium
Renin
Therapeutics

ASJC Scopus subject areas

  • Urology

Cite this

Willis, L. R., Evan, A., Connors, B. A., Shao, Y., Blomgren, P. M., Pratt, J. H., ... Lingeman, J. E. (2005). Shockwave lithotripsy: Dose-related effects on renal structure, hemodynamics, and tubular function. Journal of Endourology, 19(1), 90-101. https://doi.org/10.1089/end.2005.19.90

Shockwave lithotripsy : Dose-related effects on renal structure, hemodynamics, and tubular function. / Willis, Lynn R.; Evan, Andrew; Connors, Bret A.; Shao, Youzhi; Blomgren, Philip M.; Pratt, J. Howard; Fineberg, Naomi S.; Lingeman, James E.

In: Journal of Endourology, Vol. 19, No. 1, 01.2005, p. 90-101.

Research output: Contribution to journalArticle

Willis, LR, Evan, A, Connors, BA, Shao, Y, Blomgren, PM, Pratt, JH, Fineberg, NS & Lingeman, JE 2005, 'Shockwave lithotripsy: Dose-related effects on renal structure, hemodynamics, and tubular function', Journal of Endourology, vol. 19, no. 1, pp. 90-101. https://doi.org/10.1089/end.2005.19.90
Willis, Lynn R. ; Evan, Andrew ; Connors, Bret A. ; Shao, Youzhi ; Blomgren, Philip M. ; Pratt, J. Howard ; Fineberg, Naomi S. ; Lingeman, James E. / Shockwave lithotripsy : Dose-related effects on renal structure, hemodynamics, and tubular function. In: Journal of Endourology. 2005 ; Vol. 19, No. 1. pp. 90-101.
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