A Randomized Controlled Trial to Assess the Incidence of New Onset Hypertension in Patients After Shock Wave Lithotripsy for Asymptomatic Renal Calculi

Jewett, Michael A.S.; Bombardier, Claire; Logan, Alexander G.; Psihramis, Konstantinos E.; Wesley-James, Timothy; Mahoney, John E.; Luymes, Jacqueline J.; Ibañez, Dominique; Ryan, Michele; Honey, John

doi:10.1097/00005392-199810000-00009

Cited by 9 publications

(12 citation statements)

References 9 publications

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“…Contrary to Jewett et al [12]who found no increase in BP in asymptomatic renal stone patients after ESWL or after observation, we found a steady increase in BP in all stone patients regardless of the type of treatment or stone location. One reason for this difference might be the observation time which was only 12 months in the study by Jewett et al [12].…”

Section: Discussioncontrasting

confidence: 99%

Arterial Blood Pressure following Different Types of Urinary Stone Therapy

Strohmaier

Schmidt²,

Lahme³

et al. 2000

European Urology

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Section: Discussioncontrasting

confidence: 99%

Arterial Blood Pressure following Different Types of Urinary Stone Therapy

Strohmaier

Schmidt²,

Lahme³

et al. 2000

European Urology

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“…In particular, a number of uncontrolled and/or retrospective early reports suggested that ESWL might cause hypertension [19][20][21]. On the other hand, these postulated deleterious effects have not been confirmed by others [22][23][24][25] and two recent independent randomized controlled trials in the USA [26] and in the UK [27] have shown that there is no detectable increase in the incidence of hypertension following ESWL. In our study, patients who had received ESWL did not have higher blood pressure than those who had not received it, so any difference in blood pressure between stone-formers and controls cannot be ascribed to ESWL treatment.…”

Section: Discussionmentioning

confidence: 99%

Calcium Urolithiasis, Blood Pressure and Salt Intake

et al. 2003

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Objectives: To determine whether stone-formers have higher BP than controls drawn from the general population and matched for age, sex and ethnic origin and to compare the relationship between sodium and calcium excretion in the two groups. Patients and methods: Thirty-six patients [mean (AEstandard deviation, SD) = 49.0 AE 11.7 years; range 27-70 years] with kidney or ureteric stones and 108 controls (mean age of 49.6 AE 6.8 years; range 39-61 years), matched for gender, ethnic origin and age group were studied. Patients and controls underwent physical measurements, a venous blood sample and they were asked to collect a 24-h urine sample for sodium, potassium, calcium and creatinine. Results: Stoneformers were significantly heavier and had higher BP than age-, sex-and ethnic-matched population controls. Whilst the difference in systolic BP was independent of the difference in body mass index [16.8 mmHg (7.2-26.4 mmHg), p = 0.001), the difference in diastolic BP was attenuated after adjustment for body mass [1.8 (À3.4 to 7.1), p = 0.49]. Stone-formers passed less urine than controls [À438 ml/day (95% CI À852 to À25), p = 0.038]. They had higher urinary calcium than controls [3.7 mmol/day (2.8-4.6 mmol/day), p < 0.001], even when expressed as ratio to creatinine [0.20 (0.11-0.29), p < 0.001]. Sodium excretion was positively associated with urinary calcium in both stone-formers and in controls. The slopes were comparable (0.92 vs 0.98 mmol Ca/100 mmol Na) so that for any level of sodium excretion (or salt intake), stone-formers had a higher calcium excretion than controls. Conclusions: In stone-formers, the BP is higher than in controls. Stone-formers excrete more calcium than controls do. In stone-formers and controls, the relationship between urinary sodium and calcium is similar. Since this relationship results from an effect of sodium on calcium, a reduction in salt intake may be a useful method of reducing urinary calcium excretion in stone-formers. However, the "relative" hypercalciuria seen in stone-formers is independent of salt intake and may well reflect an underlying genetic predisposition.

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“…Development of hypertension as a late complication was reported in some studies 7,9-11 but could not be confirmed by others. 12,13 Diabetes mellitus was reported as a late complication after SWL due to acute necrotizing pancreatitis. 2,11 The majority of the studies about the side effects of SWL investigated the parenchymal damage and renal function, however, only few studies investigated the possible effect of SWL on the peristaltic movement of the ureter.…”

mentioning

confidence: 99%

Electromagnetic and Electrohydraulic Shock Wave Lithotripsy-Induced Urothelial Damage: Is There a Difference?

Mustafa

Aburas

Helo

et al. 2017

Journal of Endourology

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Purpose: To evaluate and compare the acute effect of electromagnetic and electrohydraulic extracorporeal shockwave lithotripsy (SWL) on the urothelial layers of kidney and ureter. Materials and Methods: Fifty patients, 29 males (58%) and 21 females (42%), with an average age of 51.68 years (range: 37-70) who underwent SWL application in two different centers were included. Twenty-eight patients (56%) were treated with electrohydraulic and 22 (44%) were treated with electromagnetic lithotripsy. Urinary cytologic examinations were done immediately before and after SWL therapy and 10 days later. The average numbers of epithelial cells, red blood cells (RBC), and myocytes were counted under 40 · magnification. Results: There were significant differences in the number of epithelial cells and RBC before and after immediate application of SWL: 1.66 and 14.9 cells/field, ( p = 0.001), 5.44 and 113.45 cells/field, respectively ( p = 0.001). The number of RBC was significantly higher in patients treated with electromagnetic lithotripsy than those treated with electrohydraulic: 141.9 and 93.4 cells/field, respectively ( p = 0.02). No myocyte or basement membrane elements were detected in any of the cytologic examinations. Cytologic examinations done after 10 days of SWL therapy revealed recovery of all abnormal cytologic findings. Conclusions: The acute increments in the number of epithelial cells and RBC after SWL were statistically significant but it was not permanent. SWL-induced urinary urothelial lesion is limited to the mucosal layer and there was no evidence of damage to the basal membrane or muscle layer. Electromagnetic lithotripsy caused high numbers of RBC than the electrohydraulic device on the postimmediate urine cytologic examination.

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A Randomized Controlled Trial to Assess the Incidence of New Onset Hypertension in Patients After Shock Wave Lithotripsy for Asymptomatic Renal Calculi

Abstract: The risk of hypertension in patients undergoing ESWL therapy is similar to that of a control cohort of initially observed asymptomatic patients.

Cited by 9 publications

References 9 publications

Arterial Blood Pressure following Different Types of Urinary Stone Therapy

Arterial Blood Pressure following Different Types of Urinary Stone Therapy

Calcium Urolithiasis, Blood Pressure and Salt Intake

Electromagnetic and Electrohydraulic Shock Wave Lithotripsy-Induced Urothelial Damage: Is There a Difference?

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