28 Endothelin Plasma Concentrations and Resistive Index as Parameter of Changes in Renal Perfusion After Extracorporeal Shockwave Lithotripsy

Hiros, M.; Huskić, Jasminko; Selimovic, M.; Spahović, H.; Sadović, S.; Dilić, Mirza

doi:10.1016/s1569-9056(11)60033-x

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“…A different study demonstrated no significant differences in RI values measured in various areas of the kidney post-ESWL [ 6 , 7 ]. Hiros et al [ 8 ] assessed ESWL-induced kidney perfusion disorders in both kidneys on days 1, 3 and 5 after the procedure. In the kidney subjected to ESWL, a significant increase of RI was demonstrated on days 1 and 3 after the procedure, and in the contralateral kidney the value was increased only on the first day after lithotripsy.…”

Section: Discussionmentioning

confidence: 99%

“…One theory indicates the development of interstitial oedema around peripheral branches of renal vessels as a possible cause of disorders of renal haemodynamic [ 17 ]. As a result of cellular infiltration and oedema, perivascular tissues increase their vascular resistance, as reflected by increased resistance parameters in Doppler examination [ 17 , 18 ]. Post-ESWL impairment of renal perfusion also depends on the cellular response of the vascular endothelium to the shock wave, expressed by the release of vascular status mediators.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of selected Doppler parameters of renal blood flow in patients undergoing Extracorporeal Shock Wave Lithotripsy (ESWL)

Balawender

Orkisz

2017

CEJU

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IntroductionDespite the risk of complications, which does not exceed several percent, extracorporeal shock wave lithotripsy (ESWL) causes morphological and functional changes in kidneys as a result of the effect of the generated shock wave energy on the renal parenchyma structure.Material and methodsForty-two patients were included in the study. The mean age in the studied group was 50.9 years (SD ±13.7). Extracorporeal lithotripsy treatments were carried out during the period from January 2014 to April 2014 using an electromagnetic shock wave generator. The spectrum of blood flow of the interlobar arteries of both the treated and the opposite kidney was investigated. On the basis of these spectrums, parameters such as: resistive index (RI), pulsatility index (PI) and acceleration time (AT) were calculated.ResultsThe ESWL treatment causes a statistically significant increase of the RI parameter in the ipsilateral kidney (p <0.0001) as well as in the opposite kidney (p <0.0001). The RI value decreases after 92 hours after the treatment, reaching statistical significance in both kidneys (p <0.005). The PI parameter substantially increases after treatment in both kidneys (p <0.0001), and decreases after 92 hours (p <0.0001). Statistically significant correlations are shown between RI as well as the PI parameters and the patient's age.ConclusionsExtracorporeal shock wave lithotripsy (ESWL) of renal stones causes temporary impairment of the renal perfusion in both ipsilateral and contralateral kidneys. The main factor that determines the value of the RI and PI parameters is the patient's age.

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Section: Discussionmentioning

confidence: 99%