The Effects of ESWL on Renal Function and Systemic Blood Pressure: Preliminary Report of an Experimental Study
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.
KeywordsShock Wave Glomerular Filtration Rate Plasma Renin Activity Extracorporeal Shock Wave Lithotripsy Systemic Blood Pressure
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