Simultaneous versus staged bilateral extracorporeal shock wave lithotripsy: long-term effect on renal function.

Area of Science:

• Nephrology
• Urology
• Medical Technology

Background:

• Bilateral renal calculi require effective treatment to prevent complications.
• Extracorporeal shock wave lithotripsy (ESWL) is a common modality for kidney stone treatment.
• The optimal timing for treating bilateral stones with ESWL (simultaneous vs. staged) regarding renal function impact is not fully established.

Purpose of the Study:

• To investigate and compare the long-term effects on renal function between simultaneous and staged bilateral extracorporeal shock wave lithotripsy (ESWL).

Main Methods:

• A cohort of 360 patients with bilateral renal calculi treated with ESWL between 1986 and 1995 were analyzed.
• Patients were divided into a simultaneous treatment group (n=319) and a staged treatment group (n=41).
• Renal function was assessed by serum creatinine levels with a minimum 1-year follow-up, controlling for stone burden, shock wave count, age, and follow-up duration.

Main Results:

• Long-term follow-up data (mean 3.7 years for simultaneous, 3.2 years for staged) were available for a subset of patients.
• Mean serum creatinine levels showed minimal changes in both groups post-treatment (simultaneous: +0.01, staged: -0.005).
• Statistical analysis using multiple regression revealed no significant difference in the impact on renal function between simultaneous and staged ESWL (p=0.19).

Conclusions:

• There is no clinically significant difference in the long-term renal function outcomes for patients undergoing simultaneous versus staged bilateral ESWL.
• Both treatment approaches appear safe concerning renal function preservation in the long term.
• The choice between simultaneous and staged ESWL may be based on factors other than long-term renal function impact.