Inversion, Hydration and Diuresis during Extracorporeal Shock Wave Lithotripsy: Does It Improve the Stone-Free Rate for Lower Pole Stone Clearance?

Albanis, S.; Ather, M Hammad; Papatsoris, Athanasios; Masood, Junaid; Staios, Dimitrios; Sheikh, Taufiq; Akhtar, Sobia; Buchholz, Noor

doi:10.1159/000230026

Cited by 52 publications

(26 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The altered position of the kidneys is often combined with vibration on the body surface to add some kinetic energy. This treatment approach can be used in patients with residual fragments in the lower pole of the kidneys 266–269 , although the results have been conflicting 270 .…”

Section: Discussionmentioning

confidence: 99%

Kidney stones

Khan

Pearle

Robertson

et al. 2016

Nat Rev Dis Primers

733

505

View full text Add to dashboard Cite

Kidney stones are mineral deposits in the renal calyces and pelvis that are found free or attached to the renal papillae. They contain crystalline and organic components and are formed when the urine becomes supersaturated with respect to a mineral. Calcium oxalate is the main constituent of most stones, many of which form on a foundation of calcium phosphate called Randall’s plaques, which are present on the renal papillary surface. Stone formation is highly prevalent, with rates of up to 14.8% and increasing, and a recurrence rate of up to 50% within the first 5 years of the initial stone episode. Obesity, diabetes, hypertension and metabolic syndrome are considered risk factors for stone formation, which, in turn, can lead to hypertension, chronic kidney disease and end-stage renal disease. Management of symptomatic kidney stones has evolved from open surgical lithotomy to minimally invasive endourological treatments leading to a reduction in patient morbidity, improved stone-free rates and better quality of life. Prevention of recurrence requires behavioural and nutritional interventions, as well as pharmacological treatments that are specific for the type of stone. There is a great need for recurrence prevention that requires a better understanding of the mechanisms involved in stone formation to facilitate the development of more-effective drugs.

show abstract

Section: Discussionmentioning

confidence: 99%

Kidney stones

Khan

Pearle

Robertson

et al. 2016

Nat Rev Dis Primers

733

505

View full text Add to dashboard Cite

show abstract

“…Diuretics will increase urine flow and thus the probability of cavitation [19,20]; which means, pieces of the broken stone shell increase, and the centre of the stone is exposed to subsequent shockwaves allowing entry of urine through the broken surface, thus giving an adequate interface with the centre of the stone [15]. The size of the stone is an important prognostic factor for successful ESWL and is considered as a highly effective treatment option for lower pole stones ≤2 cm [21].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of extracorporeal shockwave lithotripsy with furosemide and hydration in renal stone management: A randomised controlled trial

Sohu

Soomro

Mangrio

et al. 2019

Arab Journal of Urology

View full text Add to dashboard Cite

2019) Efficacy of extracorporeal shockwave lithotripsy with furosemide and hydration in renal stone management: A randomised controlled trial, Arab Journal of Urology, 17:4, 279-284, ABSTRACT Objective: To assess the effect of diuretics (furosemide) administered before extracorporeal shockwave lithotripsy (ESWL) followed by continuous infusion of 0.9% NaCl during the ESWL in patients with renal stones. Patients and methods: A tertiary care teaching hospital-based prospective randomised controlled trial was conducted from July 2015 to June 2017, including 714 patients who underwent ESWL. The patients were randomised in two groups: in Group-A, patients received 40 mg furosemide 30 min before each ESWL session and 1000 mL 0.9% NaCl intravenous hydration during the procedure. In Group-B, the patients only received 0.9% NaCl. All patients were followed-up every 2 weeks for 3 months with X-ray and ultrasonography of the kidney, ureter and bladder. Patients without a radio-opaque stone at follow-up were classified as successes. Results: After 2 months, the stone-free rate (SFR) was much higher in Group-A, at 77.0% vs 65.3% (P < 0.001). Further, for patients aged ≤40 years, the SFR was significantly higher in Group-A than Group-B, at 89.2% vs 71.4% (P < 0.001). The mean (SD) age of the patients was 34.4 (8.23) years. Amongst them, 441 (61.8%) were male and 273 (38.2%) were female. The mean (SD) stone size was 1.42 (0.21) cm in Group-A and 1.40 (0.20) cm in Group-B. Conclusion: We conclude that the efficacy of diuretics (furosemide) along with hydration is superior to hydration alone during ESWL for renal stone clearance.Abbreviations: BMI: body mass index; KUB: kidney, ureter and bladder; OPD: Outpatient Department; ESWL: extracorporeal shockwave lithotripsy; SFR, stone-free rate. ARTICLE HISTORY

show abstract

“…Followup at 3 months showed that 83.3% of the patients belonging to the study group were rendered stone-free, whereas 71.5% were stone-free in the control group, without statically significant difference [45]. …”

Section: Management Of Residual Stonesmentioning

confidence: 99%

Management of Clinically Insignificant Residual Fragments following Shock Wave Lithotripsy

Cicerello

Merlo

Maccatrozzo

2012

Advances in Urology

View full text Add to dashboard Cite

Clinically insignificant residual fragments (CIRFs) are small fragments (less than 5 mm) that are present in upper urinary tract at the time of regular post-SWL followup. The term is controversial because they may remain silent and asymptomatic or become a risk factor for stone growth and recurrence, leading to symptomatic events, and need further urologic treatment. Although a stone-free state is the desired outcome of surgical treatment of urolithiasis, the authors believe that the presence of noninfected, nonobstructive, asymptomatic residual fragments can be managed metabolically in order to prevent stone growth and recurrence. Further urologic intervention is warranted if clinical indications for stone removal are present.

show abstract

Inversion, Hydration and Diuresis during Extracorporeal Shock Wave Lithotripsy: Does It Improve the Stone-Free Rate for Lower Pole Stone Clearance?

Cited by 52 publications

References 30 publications

Kidney stones

Kidney stones

Efficacy of extracorporeal shockwave lithotripsy with furosemide and hydration in renal stone management: A randomised controlled trial

Management of Clinically Insignificant Residual Fragments following Shock Wave Lithotripsy

Contact Info

Product

Resources

About