Does Extracorporeal Shockwave Lithotripsy Cause Hypertension?

Montgomery, Βruce; Cole, R. S.; Palfrey, E. L. H.; Shuttleworth, K. E. D.

doi:10.1111/j.1464-410x.1989.tb05309.x

Cited by 47 publications

(8 citation statements)

References 15 publications

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“…Nevertheless, when compared to historical controls with an annualized incidence of hypertension between 3 and 6% for males aged 30–60 years, the findings were significant. This report sparked considerable interest and was soon followed by several studies that were supportive of these findings [42, 43, 44, 45, 46] and several reports of surveys that found no changes in blood pressure and no increase in the incidence of hypertension [47, 48, 49, 50, 51]. Williams et al [44] observed patients for 12–21 months after SWL and found that 8% became hypertensive and required treatment.…”

Section: Clinical Swl Adverse Effects: Who Is At Risk?mentioning

confidence: 75%

Renal Trauma and the Risk of Long-Term Complications in Shock Wave Lithotripsy

Evan¹,

Willis

Lingeman

et al. 1997

Nephron

184

123

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Open surgery for removal of upper urinary tract stones has long been associated with a high morbidity and mortality. So when shock wave (SW) lithotripsy (SWL) was introduced in the early 1980s, the climate was right for acceptance of a noninvasive method for stone comminution. The growth in popularity of SWL was extremely rapid, based in part on the perception that it was entirely safe [1]. Now, after a decade of clinical SWL, experience tells us differently. SWL may be very effective at breaking kidney stones, but it can also cause severe renal trauma that can lead to irreversible long-term complications [2, 3].

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Section: Clinical Swl Adverse Effects: Who Is At Risk?mentioning

confidence: 75%

Renal Trauma and the Risk of Long-Term Complications in Shock Wave Lithotripsy

Evan¹,

Willis

Lingeman

et al. 1997

Nephron

184

123

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“…There are a few clinical studies reporting an 8% incidence of hypertension secondary to ESWL. 20,31,32 Recently, Janetschek et al reported that eight of nine patients who had hypertension at 26 months after ESWL (patients ≥ 60 years old) had already presented with elevated RI levels immediately after ESWL. 26 The RI levels in all nine hypertensive patients showed a further increase after 26 months, whereas in the majority of normotensive patients a decrease in RI was Table 4 Reported resistive index (RI) changes Bedük et al 22 Kataoka et al 23 Knapp et al 24 observed.…”

Section: Discussionmentioning

confidence: 99%

Changes in resistive index following extracorporeal shock wave lithotripsy

et al. 1999

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Background: Extracorporeal shock wave lithotripsy (ESWL) has replaced most surgical and endourologic forms of therapy for upper urinary tract stone disease. Despite its proved safety and efficacy, its adverse effects on renal function are still to be identified. A newer diagnostic technique, color Doppler ultrasonography, has brought a new insight into renal function. It enables precise evaluation of the renal vascular supply. Changes in intrarenal vascular resistance after ESWL were studied with Doppler ultrasound techniques. Methods:In 70 consecutive patients the resistive index (RI) was measured at an interlober artery before and 30 min after ESWL in the treated and contralateral kidneys. In 17 patients, a follow-up Doppler study was performed 1 week after ESWL.Results: In the treated kidneys, the RI significantly increased from 0.656 ± 0.053 (mean ± SD) at baseline to 0.682 ± 0.053 (P < 0.0001). There was no significant correlation of increase in RI with patient age (r = 0.010) or with pre-ESWL blood pressure (r = 0.002). Elderly patients (≥ 60 years old, n = 31) had higher RI levels on baseline than younger patients (< 60 years old, n = 39). In 18 of the 31 (58.1%) elderly cases the RI were elevated to greater than 0.7, indicating pathologic changes. In younger patients, only 9 (23.1%) experienced increase in RI up to 0.7 or greater. The contralateral untreated kidneys showed significant change in RI before (0.664 ± 0.045) and after (0.679 ± 0.049) lithotripsy in elderly patients (P < 0.005). A follow-up Doppler study showed that the mean RI returned to pretreatment levels after 1 week. Conclusions: Because of higher RI levels on baseline, elderly patients have a higher risk of post-ESWL renal tissue damage than younger patients. Clinical implication of RI change in the contralateral kidneys in this study remains to be answered. The measurement of changes in RI with Doppler ultrasound techniques after ESWL may provide useful information for clinical diagnosis of renal tissue damage.

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“…Moreover, the comparison with a normal population is probably not valid since in calcium stone-formers, blood pressure is higher than in normal subjects [42]. In the British study, although the incidence of hypertension following ESWL was 4.9% after a follow-up of 29 months, there was no overall change in the mean blood pressure of the 2 groups (normotensive and hypertensive patients) [36]. Similarly, in four other studies the incidence of hypertension following Urol Int 1999;62:195-200 Bataille/Cardon/Bouzernidj/El Esper/ Pruna/Ghazali/Westeel/Achard/Fournier ESWL varyied from 1.5 to 6% and was insufficient to significantly increase the mean blood pressure [43][44][45][46].…”

Section: Hypertension Onset Following Eswl In Manmentioning

confidence: 69%