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Short-term changes in renal function after extracorporeal shock wave lithotripsy in children
K K Villányi1, J G Székely, L M Farkas
1Department of Urology, University Medical School of Pécs, Pécs, Hungary.
The Journal of Urology
|July 4, 2001
Summary
Extracorporeal shock wave lithotripsy (ESWL) in children caused temporary kidney tubule damage, evidenced by elevated enzymes. Adjusting ESWL settings and spacing treatments by at least 15 days may mitigate these effects.
Area of Science:
- Pediatric Nephrology
- Urology
- Biomedical Engineering
Background:
- Extracorporeal shock wave lithotripsy (ESWL) is a common treatment for kidney stones.
- The impact of ESWL on the immature kidney remains understudied.
- Evaluating short-term renal function changes in children post-ESWL is crucial.
Purpose of the Study:
- To assess the short-term effects of ESWL on renal function in pediatric patients.
- To investigate biochemical markers of kidney injury following ESWL in children.
Main Methods:
- A cohort of 65 children with 77 kidney stones treated with ESWL were monitored.
- Renal function was evaluated through serum and urine parameters, including electrolytes and specific enzymes.
- Urinary beta-2 microglobulin excretion was measured to assess tubular damage.
Main Results:
- No significant changes in overall renal function, serum parameters, or urine electrolytes were observed.
- A transient increase in urinary aspartate transaminase, alkaline phosphatase, lactate dehydrogenase, and beta-2 microglobulin indicated proximal tubular dysfunction.
- Kidney ultrasound showed no morphological changes, and enzyme levels normalized within 15 days.
Conclusions:
- ESWL induces transient functional damage to renal tubules in children.
- Optimizing ESWL parameters (kV and shock number) may reduce adverse effects.
- A minimum interval of 15 days between ESWL treatments is recommended to allow for functional regeneration.