Shock Wave Lithotripsy Procedures Greater Risk For Patients With Kidney Disease
INDIANAPOLIS—Patients with kidney infection or disease are at greater risk for permanent impairment when treated for kidney stones with shock wave lithotripsy, researchers at Indiana University School of Medicine reported Tuesday, June 2, at the 93rd Annual Meeting of the American Urological Association at San Diego May 30- June 4.
Andrew Evan, Ph.D., professor of anatomy at IU School of Medicine, said the purpose of the study was to determine if risk factors, such as kidney disease, could influence the long-term safety and effectiveness of shock wave lithotripsy.
Lithotripsy is used to break up kidney stones and upper ureteral stones. The shock waves apply external pressure to break the stones into tiny fragments so they can be excreted in the urine.
In an effort to mimic the condition of kidneys in many older patients, pyelonephritis, an inflammation of the kidneys, was induced in the kidneys of young pigs. The diseased kidneys were then treated with 2,000 shock waves, which is at the low end of clinical dosage. Dr. Evan said the severity of the changes caused by the shock waves were similar to the changes found in healthy kidneys exposed to much higher numbers of shock waves.
In a companion study, IU School of Medicine researchers subjected a portion of one kidney in animal models to 8,000 shock waves, the very high end of clinical dosage. The result was large and sustained reductions of blood flow and function in both kidneys. Blood flow is critical to healthy kidney function.
“The results of the experiment in diseased kidneys were similar to those in normal kidneys subjected to high dose shock wave lithotripsy,” Dr. Evan said.
“Changes in renal blood flow and urine production lasted much longer than the amount of time usually seen in animals with healthy kidneys after treatment with 2,000 shock waves,” he said.
Many patients, particularly those over the age of 60, have some degree of kidney disease or infection when treated with lithotripsy for kidney stones. An earlier study from Austria showed that 40 percent of lithotripsy patients over the age of 60 have impaired blood flow and function more than 2 years after the treatment.
“There is an apparent added risk factor for these patients and an alternative therapy might be considered by their physician,” said Dr. Evan.
Send to: Indiana University School
of Medicine
Office of Public & Media Relations
Contact: Mary Hardin
317-274-7722
mhardin@iupui.edu
INDIANA UNIVERSITY
SCHOOL OF MEDICINE
A STATEWIDE
RESOURCE
Phone
317 274 7722
Fax
317 278 8722