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A low or high BMI is a risk factor for renal hematoma after extracorporeal shock wave lithotripsy for kidney stones

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Abstract

The purpose of this study was to evaluate risk factors for renal hematoma after extracorporeal shock wave lithotripsy (SWL) for kidney stones in a matched case–control analysis of a subgroup of patients recruited from a prospective randomized cohort. Between 06/2010 and 03/2013, 418 patients underwent SWL with the MODULITH®-SLX-F2-lithotripter for kidney stones. In 39/418 patients (9 %), ultrasound at post-treatment day 1 revealed renal hematomas. For 37 of these patients, a matched group without hematoma could be selected according to the following matching criteria: age, gender, number and energy of shock waves, stone burden and localization. Risk factors for renal hematoma after SWL were compared between the two groups. The rates of diabetes, stopped anticoagulant/antiplatelet medications and arterial hypertension were not different between the two groups (p > 0.2). The skin–kidney distance was virtually the same in both groups (p = 0.5). In the hematoma group, significantly more patients had a high (>30: n = 16) as well as a low (<21.5: n = 4) BMI when compared to the control group (n = 4; n = 0; p < 0.001). Importantly, all patients with BMI <21.5 developed renal hematomas after SWL. Patients with a high (>30) or low (<21.5) BMI had a higher risk for renal damage after SWL. Therefore, alternative endoscopic treatment options should be considered in these patients.

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References

  1. Chaussy C, Schmiedt E, Jocham D, Brendel W, Forssmann B, Walther V (1982) First clinical experience with extracorporeally induced destruction of kidney stones by shock waves. J Urol 127:417–420

    CAS  PubMed  Google Scholar 

  2. Pearle MS, Goldfarb DS, Assimos DG et al (2014) Medical management of kidney stones: AUA guideline. J Urol 192:316–324

    Article  PubMed  Google Scholar 

  3. Türk CKT, Petrik A, Sarica K, Skolarikos A, Straub M, Seitz C (2015) Guidelines on urolithiasis: European Association of Urology. http://www.uroweborg/guidelines

  4. Sayed MA, El-Taher AM, Aboul-Ella HA, Shaker SE (2001) Steinstrasse after extracorporeal shockwave lithotripsy: aetiology, prevention and management. BJU Int 88:675–678

    Article  CAS  PubMed  Google Scholar 

  5. Skolarikos A, Alivizatos G, de la Rosette J (2006) Extracorporeal shock wave lithotripsy 25 years later: complications and their prevention. Eur Urol 50(5):981–990

    Article  PubMed  Google Scholar 

  6. Tan YM, Yip SK, Chong TW, Wong MY, Cheng C, Foo KT (2002) Clinical experience and results of ESWL treatment for 3,093 urinary calculi with the Storz Modulith SL 20 lithotripter at the Singapore general hospital. Scan J Urol Nephrol 36:363–367

    Article  CAS  Google Scholar 

  7. Dhar NB, Thornton J, Karafa MT, Streem SB (2004) A multivariate analysis of risk factors associated with subcapsular hematoma formation following electromagnetic shock wave lithotripsy. J Urol 172:2271–2274

    Article  PubMed  Google Scholar 

  8. Wen CC, Nakada SY (2007) Treatment selection and outcomes: renal calculi. Urol Clin North Am 34:409–419

    Article  PubMed  Google Scholar 

  9. Martin Martinez JC, Diez Cordero JM, Duran Merino R et al (1995) Subcapsular renal hematoma following shock wave lithotripsy. Arch Esp Urol 48:179–184

    CAS  PubMed  Google Scholar 

  10. Collado Serra A, Huguet Perez J, Monreal Garcia de Vicuna F, Rousaud Baron A, Izquierdo de la Torre F, Vicente Rodriguez J (1999) Renal hematoma as a complication of extracorporeal shock wave lithotripsy. Scan J Urol Nephrol 33:171–175

    Article  CAS  Google Scholar 

  11. Knapp PM Jr, Konnak JW, McGuire EJ, Savastano JA (1987) Urodynamic evaluation of ileal conduit function. J Urol 137:929–932

    PubMed  Google Scholar 

  12. Kostakopoulos A, Stavropoulos NJ, Macrychoritis C, Deliveliotis C, Antonopoulos KP, Picramenos D (1995) Subcapsular hematoma due to ESWL: risk factors. A study of 4,247 patients. Urol Int 55:21–24

    Article  CAS  PubMed  Google Scholar 

  13. Lee HY, Yang YH, Shen JT et al (2013) Risk factors survey for extracorporeal shockwave lithotripsy-induced renal hematoma. J Endourol 27:763–767

    Article  PubMed  Google Scholar 

  14. Razvi H, Fuller A, Nott L et al (2012) Risk factors for perinephric hematoma formation after shockwave lithotripsy: a matched case-control analysis. J Endourol 26:1478–1482

    Article  PubMed  Google Scholar 

  15. Skuginna V, Nguyen DP, Seiler R, Kiss B, Thalmann GN, Roth B (2016) Does stepwise voltage ramping protect the kidney from injury during extracorporeal shockwave lithotripsy? Results of a prospective randomized trial. Eur Urol 69:267–273

    Article  PubMed  Google Scholar 

  16. Zehnder P, Roth B, Birkhauser F et al (2011) A prospective randomised trial comparing the modified HM3 with the MODULITH(R) SLX-F2 lithotripter. Eur Urol 59:637–644

    Article  PubMed  Google Scholar 

  17. Preminger GM, Assimos DG, Lingeman JE, Nakada SY, Pearle MS, Wolf JS Jr. (2005) Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol 173:1991–2000

    Article  PubMed  Google Scholar 

  18. Drach GW, Dretler S, Fair W et al (1986) Report of the United States cooperative study of extracorporeal shock wave lithotripsy. J Urol 135:1127–1133

    CAS  PubMed  Google Scholar 

  19. Mezentsev VA (2005) Extracorporeal shock wave lithotripsy in the treatment of renal pelvicalyceal stones in morbidly obese patients. Int Braz J Urol 31:105–110

    Article  CAS  PubMed  Google Scholar 

  20. Alessi MC, Juhan-Vague I (2008) Metabolic syndrome, haemostasis and thrombosis. Thromb Haemost 99:995–1000

    CAS  PubMed  Google Scholar 

  21. Kostapanos M, Florentin M, Elisaf MS, Mikhailidis DP (2013) Hemostatic factors and the metabolic syndrome. Curr Vasc Pharmacol 11:880–905

    Article  CAS  PubMed  Google Scholar 

  22. Hatiboglu G, Popeneciu V, Kurosch M et al (2011) Prognostic variables for shockwave lithotripsy (SWL) treatment success: no impact of body mass index (BMI) using a third generation lithotripter. BJU Int 108:1192–1197

    Article  PubMed  Google Scholar 

  23. Pareek G, Armenakas NA, Panagopoulos G, Bruno JJ, Fracchia JA (2005) Extracorporeal shock wave lithotripsy success based on body mass index and Hounsfield units. Urology 65:33–36

    Article  PubMed  Google Scholar 

  24. Miller GJ, Martin JC, Webster J et al (1986) Association between dietary fat intake and plasma factor VII coagulant activity—a predictor of cardiovascular mortality. Atherosclerosis 60:269–277

    Article  CAS  PubMed  Google Scholar 

  25. Newman LH, Saltzman B (1991) Identifying risk factors in development of clinically significant post-shock-wave lithotripsy subcapsular hematomas. Urology 38:35–38

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland

    Fabio Nussberger, Beat Roth, Tobias Metzger, Bernhard Kiss, George N. Thalmann & Roland Seiler

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  1. Fabio Nussberger
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  2. Beat Roth
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  3. Tobias Metzger
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  4. Bernhard Kiss
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  5. George N. Thalmann
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  6. Roland Seiler
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Correspondence to Roland Seiler.

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All authors confirm that all work was designed and conducted by all the authors; the manuscript has been written, read, and approved by all the authors; the manuscript, or parts of it, have not been and will not be submitted elsewhere for publication; and there are no conflicts of interest by any of the authors.

In this study, human participants are involved. The study protocol was approved by the ethics committee of Bern Canton, Switzerland (Protocol Number 089/10), and all patients provided informed written consent.

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There are no conflicts of interest by any of the authors.

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Nussberger, F., Roth, B., Metzger, T. et al. A low or high BMI is a risk factor for renal hematoma after extracorporeal shock wave lithotripsy for kidney stones. Urolithiasis 45, 317–321 (2017). https://doi.org/10.1007/s00240-016-0915-4

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  • DOI: https://doi.org/10.1007/s00240-016-0915-4

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