Renal morphology and function immediately after extracorporeal shock-wave lithotripsy.

Area of Science:

• Nephrology
• Urology
• Radiology

Background:

• Kidney stones are a common ailment requiring treatment.
• Extracorporeal shock-wave lithotripsy (ESWL) is a primary method for treating kidney stones.
• Understanding the acute effects of ESWL on kidney morphology and function is crucial for patient management.

Purpose of the Study:

• To evaluate the immediate impact of ESWL on kidney structure and function.
• To assess the diagnostic capabilities of excretory urography, quantitative radionuclide renography (QRR), and magnetic resonance imaging (MRI) in detecting ESWL-induced changes.

Main Methods:

• A prospective study involving 33 patients undergoing ESWL.
• Utilized excretory urography, QRR, and MRI to assess kidney morphology and function post-treatment.
• Analyzed imaging findings for signs of kidney enlargement, ureteral obstruction, parenchymal changes, and other abnormalities.

Main Results:

• ESWL led to kidney enlargement in 18% and ureteral obstruction in 37% of treatments.
• Quantitative radionuclide renography showed partial or total parenchymal obstruction in 25% and 22% of kidneys, respectively.
• Magnetic resonance imaging revealed abnormalities in 63% of treated kidneys, including loss of corticomedullary differentiation and fluid collections. Overall, 74% of treated kidneys showed abnormalities on at least one imaging modality.

Conclusions:

• ESWL can cause significant acute morphologic and functional changes in the kidney.
• These changes are primarily attributed to renal contusion, leading to edema and extravasation of urine and blood.
• While imaging often detects abnormalities, the clinical significance and long-term implications require further investigation.