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Renal function after bilateral extracorporeal shockwave lithotripsy

A S Cass1

  • 1Midwest Urologic Stone Unit, Hennepin County Medical Center, Minneapolis, MN.

Journal of Endourology
|December 1, 1994
PubMed
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Bilateral shock wave lithotripsy (SWL) for kidney stones did not cause early renal failure. Long-term function decline was linked to multiple stones and repeat treatments, not bilateral SWL itself.

Area of Science:

  • Nephrology
  • Urology
  • Medical Engineering

Background:

  • Simultaneous bilateral renal shock wave lithotripsy (SWL) is a treatment for kidney stones.
  • Assessing long-term renal function after bilateral SWL is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate renal function changes in patients undergoing simultaneous bilateral renal SWL.
  • To identify factors influencing long-term renal function after SWL.

Main Methods:

  • Studied 56 patients an average of 44 months post-SWL.
  • Calculated glomerular filtration rate (GFR) using an empiric formula.
  • Defined clinically significant renal function deterioration as a GFR change of ≥20%.

Main Results:

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  • No early acute renal failure observed.
  • Patients with higher initial creatinine showed improved GFR post-SWL due to obstruction relief.
  • Among patients with lower initial creatinine, 18% experienced a significant GFR decrease (>20%), associated with multiple stones and repeat SWL.
  • Literature review suggested long-term function decline in some solitary kidneys or those with untreated contralateral kidneys.

Conclusions:

  • Simultaneous bilateral renal SWL does not appear to influence the long-term reduction in renal function.
  • Multiple renal stones and repeat SWL are associated with a greater risk of decreased renal function post-treatment.
  • The presence of an untreated contralateral kidney does not consistently aid long-term recovery of the treated kidney's function.