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Long-term follow-up of renal morphology and function in children after lithotripsy
Insights
Extracorporeal shock wave lithotripsy (ESWL) is safe and effective for pediatric kidney stones. Long-term follow-up shows no significant changes in renal function, morphology, or stone recurrence rates.
Area of Science:
- Pediatric Urology
- Nephrology
- Medical Devices
Background:
- Pediatric kidney stone treatment requires safe and effective methods.
- Extracorporeal shock wave lithotripsy (ESWL) is a potential option for children.
Purpose of the Study:
- To evaluate the long-term safety and efficacy of ESWL in pediatric patients.
- To assess renal function, morphology, blood pressure, and stone recurrence after ESWL.
Main Methods:
- ESWL performed on 35 children using Dornier MPL 9000 Lithotriptor under sedation.
- Regular 6-month follow-up including radiosiotope renogram, sonography, and blood pressure monitoring.
- Analysis of renal functional and morphological alterations, blood pressure changes, and stone recurrence rates.
Main Results:
- Transient decrease in renal function observed in the first 0-3 months post-ESWL, returning to normal limits.
- No significant gross pathology, altered renal dimensions, or changes in parenchymal thickness noted on sonography.
- No statistically significant changes in blood pressure or stone recurrence rates observed during long-term follow-up.
Conclusions:
- ESWL is a safe and effective treatment modality for pediatric kidney stones.
- Long-term evaluation confirms the safety of ESWL in children, with no adverse effects on renal health or stone recurrence.
Abstract:
Between October 1990 and May 1991, extracorporeal shock wave lithotripsy (ESWL) was performed on 35 children. All the treatments were done with the Dornier MPL 9000 Lithotriptor under sedation. Following treatment all the children were controlled regularly every 6 months, and the long-term follow-up results concerning the renal functional and morphological alterations together with changes in blood pressure values and the rate of stone recurrence were analyzed. Renal functional evaluations using a radiosiotope renogram revealed a transient decrease in renal function in the early follow-up period (0-3 months), which returned to normal limits after this period. Sonographic evaluation of the renal dimensions and morphology did not show any gross pathology in the early and long-term evaluation. Again determination of renal parenchymal thickness together with renal growth showed no statistically significant alteration in the late control of the children. Finally, careful monitoring of blood pressure and the recurrence rate of stone disease revealed no statistically significant changes in these aspects. ESWL seems to be the preferred treatment modality in children due to its safe and effective therapy results. Especially the long-term evaluation of our children proved the safety of this procedure.