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Extracorporeal shock-wave lithotripsy: long-term complications
C M Williams1, J V Kaude, R C Newman
1Department of Radiology, University of Florida College of Medicine, FL.
AJR. American Journal of Roentgenology
|February 1, 1988
Summary
Extracorporeal shock-wave lithotripsy (ESWL) can lead to decreased kidney function and hypertension in patients. About 8% of patients develop significant hypertension requiring treatment within 21 months after ESWL for renal lithiasis.
Area of Science:
- Nephrology
- Urology
- Medical Technology Assessment
Background:
- Renal lithiasis (kidney stones) is a common condition.
- Extracorporeal shock-wave lithotripsy (ESWL) is a primary treatment for kidney stones.
- Potential long-term effects of ESWL on renal function and blood pressure require investigation.
Purpose of the Study:
- To evaluate the long-term effects of ESWL on renal function and blood pressure.
- To determine the incidence of hypertension following ESWL for renal lithiasis.
Main Methods:
- Follow-up study of 148 patients treated with ESWL for renal lithiasis.
- Renal function tests including quantitative radionuclide renography were performed.
- Blood pressure measurements were taken at 17-21 months post-ESWL.
Main Results:
- A statistically significant decrease in effective renal plasma flow (ERPF) to the treated kidney was observed (p = .048).
- Systolic (p = .0002) and diastolic (p = .015) blood pressures significantly increased in patients.
- Eight percent (8%) of patients developed hypertension requiring treatment within 21 months.
Conclusions:
- ESWL for renal lithiasis is associated with a potential permanent decrease in renal function.
- Hypertension is a significant complication of ESWL, occurring in approximately 8% of patients.
- The pathogenesis of ESWL-induced hypertension remains unknown but warrants clinical attention.