Pathologic effects of ESWL on canine renal tissue

The introduction of extracorporeal shock wave lithotripsy (ESWL) has provided an avenue for dealing with many urinary stones noninvasively. The margin of safety for the kidney during shock wave administration is largely undefined. A pilot study was performed where six kidneys in five female mongrel dogs were shocked. Group A kidneys were given 1,776, 4,500, 6,000, or 8,000 shocks, respectively, at 18-24 kV. Group B kidneys received 1,600 and 8,000 shocks (18-24 kV). The number of shocks per electrode ranged from 500 to 4,538 and averaged 2,490. The dogs were sacrificed forty-eight to seventy-two hours (Group A) or twenty-eight to thirty-two days (Group B) post-treatment. Modest damage (hematoma and/or interstitial hemorrhage) was noted in all kidneys. Evidence of permanent change (fibrosis) was noted in both Group B kidneys. Complete necrosis of the kidney was not seen after administration of 8,000 shocks. These preliminary data indicate that lithotripsy can, in some circumstances, produce renal damage in the canine model.