Extracorporeal shock wave therapy does not improve hypertensive nephropathy

Area of Science:

• Nephrology
• Regenerative Medicine
• Cardiovascular Research

Background:

• Low-energy extracorporeal shock wave therapy (SWT) promotes angiogenesis and has shown therapeutic effects in various conditions.
• Chronic kidney diseases (CKD) are characterized by renal fibrosis and capillary rarefaction, suggesting potential benefit from proangiogenic treatments.
• Hypertensive nephropathy is a common form of CKD involving renal damage and impaired function.

Purpose of the Study:

• To investigate the efficacy of SWT in ameliorating renal repair and promoting angiogenesis in a rat model of L-NAME-induced hypertensive nephropathy.
• To assess the impact of SWT on blood pressure, renal function, urinary protein excretion, and histological damage.
• To evaluate the effect of SWT on angiogenesis markers and gene expression in the kidneys.

Main Methods:

• Rats with L-NAME-induced hypertensive nephropathy were treated with low-energy SWT (0.09 mJ/mm², 400 shots, 3 times/week) for 4 weeks.
• Blood pressure, renal function (creatinine, proteinuria), and histological parameters (glomerulosclerosis, arteriolosclerosis, tubular dilatation, interstitial fibrosis) were assessed.
• Peritubular capillary density and gene expression of angiogenesis markers (eNOS, VEGF, VEGF-R, SDF-1) were analyzed.

Main Results:

• SWT treatment did not significantly alter blood pressure, renal function, or urinary protein excretion compared to untreated rats.
• Histological analysis revealed no significant differences in renal lesions between SWT-treated and untreated groups.
• SWT did not enhance peritubular capillary density or upregulate the expression of key angiogenesis-related genes.

Conclusions:

• Extracorporeal kidney shock wave therapy, at the tested parameters, does not induce therapeutic angiogenesis or improve renal function and structure in this model of hypertensive nephropathy.
• The study suggests that SWT may not be a suitable proangiogenic treatment for hypertensive nephropathy.
• The treatment was well-tolerated with no observed adverse effects in either control or hypertensive rats.