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.

The Role for Active Monitoring in Urinary Stones: A Systematic Review

“…Unfortunately, the authors do not comment on the stone burden after treatment or on admission rates for those patients who were treated with SWL. 36 In the second trial, patients with caliceal stones <15 mm in total diameter were randomized to undergo SWL (n ¼ 113) or observation (n ¼ 115). 4 Mean follow-up was 2.2 years (range 1-5 yrs).…”

Effect of High Shock Number on Acute Complication Development After Extracorporeal Shockwave Lithotripsy

“…Research has documented renal scarring with loss of functional renal mass after SWL, which appears secondary to vascular damage and inflammation induced by the procedure. 1,[7][8][9][10][11] In contrast to early animal studies, more recent research suggests that shockwaves may cause dosedependent acute renal injury. 10,11 As McAteer and Evan 11 describe, however, in an animal model without a normal in vivo physiologic response, extrapolating the clinical consequences of such renal damage is difficult.…”

“…1,[6][7][8][9][10][11] Such findings provide limited clinical guidance and add to questions regarding the short-and long-term safety of SWL for patients. As a result, clinical practice intuition regards the administration of a high shock number ( > 2400) with caution even in the presence of residual stone.…”

Complications of Extracorporeal Shock Wave Lithotripsy for Urinary Stones: To Know and to Manage Them—A Review

“…The diagnosis of hypertension after SWL has been reported in 8% of cases, that does not differ greatly however from the incidence of about 6% of new diagnosis in the overall population [40]. An increase in diastolic pressure after an SWL was also noted, and a relationship between this and the number of shock waves was therefore hypothesised upon [41].…”

“…Limiting oneself to randomly controlled studies there is no evidence that SWL treatment determines changes in arterial pressure [40, 44]; in fact, it is possible that the extracorporeal lithotripsy is responsible for hypotension, and likewise for alterations in renal metabolism determined by the treatment and function of the number and strength of shock waves administered [45]. …”