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[Quantitative renal DMSA scintigraphy after extracorporeal lithotripsy]
1Service de Chirurgie Urologique, Hôpital d'Adultes Timone, Marseille.
Annales D'Urologie
|January 1, 1990
Summary
Extracorporeal lithotripsy can cause kidney damage, as shown by DMSA isotope scans. Lower frequency settings may reduce these renal modifications, but further multicenter studies are needed to optimize treatment.
Area of Science:
- Nephrology
- Urology
- Radiology
Background:
- Extracorporeal lithotripsy (ECL) is a common treatment for renal stones.
- Potential renal parenchymal damage following ECL necessitates careful evaluation.
Purpose of the Study:
- To assess renal modifications after ECL using DMSA isotope scans.
- To correlate ECL parameters with the incidence and severity of renal sequelae.
Main Methods:
- Renal DMSA isotope scans were performed before and after ECL in 106 patients.
- Scans were conducted on day 4 and day 90 post-treatment.
- Results were analyzed based on ECL technique evolution (firing rates) and stone characteristics.
Main Results:
- ECL induced observable renal modifications, including scarring, detected by DMSA scans.
- High firing rates correlated with a 40% success rate and renal scars in 2/3 of cases.
- Low frequency firing rates showed improved success rates (55-60%) and fewer, often reversible, renal changes.
Conclusions:
- Lithotripsy demonstrably induces renal modifications, indicating the renal parenchyma's sensitivity to treatment parameters.
- Lower frequency settings appear to mitigate renal damage.
- Standardized multicenter studies are crucial for comparing lithotriptors and establishing evidence-based treatment guidelines for renal stones.