Studies Focus on Harms of Lithotripsy

Patients treated with shock wave lithotripsy may be at risk for permanent kidney injury, researchers at IUSM reported at the 93rd Annual Meeting of the American Urological Association.

Two IUSM professors, Andrew Evan, PhD, professor of anatomy, and Lynn Willis, PhD, professor of pharmacology and toxicology and of medicine, presented different but equally alarming discoveries about the acclaimed shock wave lithotripsy used to break up kidney stones and upper ureteral stones.

By studying shock wave lithotripsy in pigs, Dr. Willis and his research team discovered that the length and severity of kidney impairment caused by lithotripsy may be directly linked to the number of shock waves used to treat kidney stones. Researchers reported that the 8000 shock wave level caused subjects large and sustained reductions of blood flow and function in both kidneys. Dr. Willis says this could affect the kidney's ability to control pressure or lead to kidney failure.

Dr. Evan's research team studied the presence of kidney disease during lithotripsy treatments. They discovered that patients with kidney infection or disease are more susceptible to kidney damage produced by shock wave therapy. "There is an apparent added risk factor for these patients," he says. "Patients should consider alternative therapies."

Drs. Evan, Willis and colleagues recently received a $4.15 million, five-year grant from the National Institutes of Health to continue their research into the long-term effects of shock wave lithotripsy in the treatment of kidney stones. The grant renews a project grant first awarded in 1994. Dr. Evan is principal investigator.