Effect of Renal Shock Wave Lithotripsy on the Development of Metabolic Syndrome in a Juvenile Swine Model: A Pilot Study

Abstract

Purpose A pilot study was conducted to assess whether renal shock wave lithotripsy (SWL) influences the onset and severity of metabolic syndrome (MetS). Materials and Methods Three-month-old juvenile female Ossabaw miniature pigs were treated with SWL (2000 SWs, 24 kV, 120 SWs/min using the HM3 lithotripter; n=2) or sham-SWL (no SWs; n=2). SWs were targeted to the upper pole of the left kidney so as to model treatment that would also expose the pancreatic tail to SWs. Pigs were then instrumented for direct measurement of arterial blood pressure via an implanted radiotelemetry device, and later fed a hypercaloric atherogenic diet for ~7 months. The development of MetS was assessed from intravenous glucose tolerance tests (IVGTTs). Results The progression and severity of MetS was similar in the sham-treated and SWL-treated groups. The only exception was with respect to arterial blood pressure, which remained relatively constant in the sham-treated pigs but began to rise at ~2 months towards hypertensive levels in SW-treated pigs. Metabolic data from both groups were pooled to provide a more complete assessment of the development and progression of MetS in this juvenile pig model. IVGTTs revealed substantial insulin resistance with impaired glucose tolerance within 2 months on the hypercaloric atherogenic diet with signs of further metabolic impairment at 7 months. Conclusions These preliminary results suggest that renal SWL is not a risk factor for worsening of glucose tolerance or the onset of diabetes mellitus, but does appear to be a risk factor for early onset hypertension in MetS.

Intraluminal measurement of papillary duct urine pH, in vivo: a pilot study in the swine kidney

“…an acidification defect in the SW-treated kidney [25]. We have also recently documented remodeling of nephron structures in SWL-treated regions of the kidney, which could potentially impact tubule acidification processes [25, 26]. With the limitations of this current pilot study (see below) it would be premature to draw firm conclusions linking a change in ductal urine pH to injury caused by SWL.…”

Swine Disease Models for Optimal Vascular Engineering

“…Renal morphology and function in pigs are similar to those in humans (55,56). The size of the pig kidney is also similar to the human kidney, thus enabling interventions with the same methods used in humans, such as lithotripsy (56) or optical fiber catheters that allow rapid determination of the glomerular filtration rate. The catheters were tested for safety and efficacy in pigs (57) and quickly advanced to human clinical trials (58).…”

Effect of metabolic syndrome and aging on Ca2+ dysfunction in coronary smooth muscle and coronary artery disease severity in Ossabaw miniature swine

“…Lean old swine were shown to be healthy, as indicated by their body weight, cholesterol, triglycerides, and blood glucose measurements derived from the IVGTT assessment. Our laboratory and others have extensively characterized cardiometabolic profiles in Ossabaw swine fed regular chow diets and hypercaloric, atherogenic diets to induce MetS (13, 27, 44, 51, 52, 54, 55, 69). MetS was confirmed in the MetS young and MetS old swine groups, both of which developed obesity, hypercholesterolemia, and elevated peak glucose and area under the curve during IVGTTs (52, 54).…”