Advertisement

The Effects of ESWL on Renal Function and Systemic Blood Pressure: Preliminary Report of an Experimental Study

  • Erdal Erturk
  • Stevan B. Streem
  • Nicholas T. Stowe
  • Jose Pestana
  • Joseph V. Nally
  • Ronald Lorig
  • Gordon Gephart
  • Andrew C. Novick

Abstract

Extracorporeal shock wave lithotripsy (ESWL) is a relatively new therapy for most urinary stones. The effects of high energy shock waves on human renal tissue is difficult to assess. Recent studies indicate that direct injury to the kidney from high energy shock waves can occur. This insult may result in a decrease in renal function and an elevation of the systemic blood pressure. The purpose of this study was to develop an animal model where any alterations in renal function or in systemic blood pressure could be followed after ESWL. In a pilot study, the kidneys of uninephrectomized dogs (n=5) were subjected to 3,000 shocks at 18 kV of power with the Dornier HM3 unit. Systemic blood pressure was determined before and after treatment at 24 hours, at 48 hours, and at four weeks after ESWL. In addition, glomerular filtration rate (inulin clearance) and plasma renin activity were measured. Transient elevations in blood pressure with concomitant decreases in glomerular filtration rate (GFR) and increases in plasma renin activity were noted in some experiments. While the dog is a difficult model in which to produce hypertension, this approach offers a reasonable way to study the relationship between alterations in renal function and systemic blood pressure following ESWL.

Keywords

Shock Wave Glomerular Filtration Rate Plasma Renin Activity Extracorporeal Shock Wave Lithotripsy Systemic Blood Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Chaussy C: Extracorporeal Shock Wave Lithotripsy: New Aspects in the Treatment of Kidney Stone Disease. Basel, Switzerland: Karger, 1982.Google Scholar
  2. 2.
    Brendel W: Effect of shock waves on canine kidneys. In Gravenstein JS and Peter K (eds): Extracorporeal Shock Wave Lithotripsy for Renal Stone Disease: Technical and Clinical Aspects. Stoneham, MA: Butterworths, 1986.Google Scholar
  3. 3.
    Newman RC, Hackett R, Senior D, et al: Pathologic effects of extracorporeal shock wave lithotripsy on canine renal tissue. Urology 29: 195, 1987.Google Scholar
  4. 4.
    Drach GW, Dretler SP, Fair WR, et al: Report of the United States cooperative study of extracorporeal shock wave lithotripsy. J Urol 135: 1127, 1986.PubMedGoogle Scholar
  5. 5.
    Kaude JV, Williams CM, Millner MR, et al: Renal morphology and function immediately after extracorporeal shock wave lithotripsy. AJR 145: 305, 1985.PubMedCrossRefGoogle Scholar
  6. 6.
    Lingeman JE, Kulb TB, Newman DM, et al: Hypertension following extracorporeal shock wave lithotripsy. J Urol 137: 142A (abstract), 1987.Google Scholar
  7. 7.
    Chaussy C, Schmiedt E, Jocham D: Extracorporeal shock wave lithotripsy for treatment of urolithiasis. Urology 23: 59, 1984.PubMedCrossRefGoogle Scholar
  8. 8.
    Lingeman JE, Newman DM, Mertz JHO, et al: Extracorporeal shock wave lithotripsy: the Methodist Hospital of Indiana experience. J Urol 135: 1134, 1986.PubMedGoogle Scholar
  9. 9.
    Rubin JI, Arger PH, Pollack HM, et al: Kidney changes after extracorporeal shock wave lithotripsy: CT evaluation. Radiology 162: 21, 1987.PubMedGoogle Scholar
  10. 10.
    Baumgartner BR, Dickey KW, Ambrose SS, et al: Kidneys after extracorporeal shock wave lithotripsy: appearance on MR imaging. Radiology 163: 531, 1987.PubMedGoogle Scholar
  11. 11.
    Ruiz-Marcellan FJ and Ibraz-Servio L: Evaluation of renal damage in extracorporeal lithotripsy by shock waves. Eur Urol 12: 73, 1986.PubMedGoogle Scholar
  12. 12.
    Peterson JC and Finlayson B: Effects of extracorporeal shock wave lithotripsy on blood pressure. In Gravenstein JS and Peter K (eds): Extracorporeal Shock Wave Lithotripsy for Renal Stone Disease, Stoneham, MA: Butterworths, 1986.Google Scholar
  13. 13.
    Page IH: Production of persistent arterial hypertension by cellophane perinephritis. JAMA 113: 2046, 1939.CrossRefGoogle Scholar
  14. 14.
    Sufrin G: The Page kidney: a correctable form of hypertension. J Urol 113: 450, 1979.Google Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Erdal Erturk
    • 1
  • Stevan B. Streem
    • 1
  • Nicholas T. Stowe
    • 1
    • 2
  • Jose Pestana
    • 1
  • Joseph V. Nally
    • 2
  • Ronald Lorig
    • 3
  • Gordon Gephart
    • 4
  • Andrew C. Novick
    • 1
  1. 1.Department of UrologyCleveland Clinic FoundationClevelandUSA
  2. 2.Department of Hypertension and NephrologyCleveland Clinic FoundationClevelandUSA
  3. 3.Department of RadiologyCleveland Clinic FoundationClevelandUSA
  4. 4.Department of PathologyCleveland Clinic FoundationClevelandUSA

Personalised recommendations