Long-Term Effects of Extracorporeal Shock Wave Lithotripsy on Renal Function: Our Experience With 156 Patients With Solitary Kidney

El‐Assmy, Ahmed; El-Nahas, Ahmed R.; Hekal, Ihab A.; Badran, Mohamed Aboelnour; Youssef, Ramy; Sheir, Khaled Z.

doi:10.1016/j.juro.2008.01.095

Cited by 35 publications

(18 citation statements)

References 17 publications

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“…Not only do urologic procedures manage the kidney stone event itself, our study provides evidence that they may help to prevent long-term deterioration in kidney function as seen in previous studies. 6,[12][13][14][15][16][17] Limitations There were several limitations to this study. Patients with kidney stones were identified either by seeking medical care for symptoms related to an acute episode or incidentally on imaging such as computed tomography or ultrasound.…”

Section: Hazards Among Stone Formers After Urologic Proceduresmentioning

confidence: 98%

“…Female gender and an immediate postoperative improvement in the modification of diet in renal disease eGFR are predictive of a sustained increase in that rate of renal preservation. 16 El-Asemy et al 17 did not find any significant effect on renal function or blood pressure at the one-year follow-up after ESWL in patients with a solitary kidney. Percutaneous nephrolithotomy, ESWL, or the two techniques combined were found to be equally efficacious for preserving renal function in patients with solitary kidney.…”

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confidence: 91%

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Urological Procedures in Urolithiasis and Their Association with Chronic Kidney Disease

D'Costa

Savcic-Kos²,

Huang

et al. 2016

Clin Med Res

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Background and Objectives: Epidemiological evidence suggests that patients with urolithiasis are at increased risk for end-stage renal disease (ESRD). It is unclear if urological intervention impacts the progression of chronic kidney disease (CKD). Methods:We conducted a retrospective observational cohort study of patients in the Marshfield Epidemiologic Study Area database between January 1991 and May 2007, where 1,340 patients diagnosed with urolithiasis were extracted. Of the 1,340 subjects, 446 had urological procedures for management of urolithiasis. Those that underwent these procedures were compared to those that did not. Cox proportional hazards models adjusted for age, gender, and comorbidities were performed to evaluate the risk for CKD, elevated serum creatinine, and any-cause mortality. Results:Baseline comorbidities in patients with and without procedures were not significantly different except for obesity (P<0.0001). Subjects that underwent procedures were at increased risk for elevated serum creatinine (Hazard Ratio (HR) [95% CI] =1.49 [1.19-1.85]) when compared to those that did not undergo a urologic procedure during the study period. The results did not reveal a significant difference in incidence of CKD or any-cause mortality. Conclusions:Patients who undergo urologic procedures are at increased risk for elevated creatinine. Urological procedures do not appear to impact incidence of CKD or mortality and, in fact, may prevent long-term renal dysfunction. Keywords: Chronic kidney disease; Urolithiasis; Nephrolithiasis; Urological procedures T he burden of urolithiasis has been increasing, with lifetime incidences of 10% for men and 5% for women in recent studies. [1][2][3][4][5] Early clinical observations suggest that certain nephrolithiasis conditions (eg, staghorn calculi) and genetic diseases (eg, primary hyperoxaluria; dental disease; 2,8-hydroxyadenine crystalluria; cystinuria) are leading to progressive loss of epidermal growth factor receptor (eGFR) and end-stage renal disease (ESRD) at a younger age. 6 An increasing number of studies have been done over the past few years concerning the relationship between kidney stones (nephrolithiasis/urolithiasis) and the development of chronic kidney disease (CKD). Clinical Medicine & Research1-7 Kidney stones were found to be a risk factor for CKD in a recent study by a group at the Mayo Clinic in Rochester, MN.3 Alexander et al 7 found that even a single kidney stone episode was associated with a significant increase in the risk of adverse renal outcomes including ESRD, with median follow up of 11 years. A large prospective cohort study of people in the United Kingdom found that kidney stones posed a significant risk for ESRD in women, but not in men. They explained this difference by noting anatomical protection from obstructive complications due to differences in anatomy. 5 Several studies have shown an association between nephrolithiasis and certain comorbidities. More recently, the association between nephrolithiasis and an increased risk of ...

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Section: Hazards Among Stone Formers After Urologic Proceduresmentioning

confidence: 98%

mentioning

confidence: 91%

Urological Procedures in Urolithiasis and Their Association with Chronic Kidney Disease

D'Costa

Savcic-Kos²,

Huang

et al. 2016

Clin Med Res

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“…39 The association between ESWL and the development of chronic diseases (hypertension and diabetes) is unclear and studies with higher levels of evidence are needed to confirm or rule out this association (Level of evidence 2b; Grade of recommendation B). Lastly, in relation to a possible worsening of renal function after ESWL, in a study of 156 patients with a single kidney undergoing ESWL and an average follow up of 3.8 years, El-Assmy et al 40 found no changes in creatinine levels, demonstrating the safety of this method at least in the medium term (Level of evidence: 3; Grade of recommendation B).…”

Section: Complicationsmentioning

confidence: 99%

Extracorporeal shock wave lithotripsy in the treatment of renal and ureteral stones

Torricelli

Danilovic

Vicentini

et al. 2015

Rev. Assoc. Med. Bras.

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Conflict of interest: noneThe use of certain technical principles and the selection of favorable cases can optimize the results of extracorporeal shock wave lithotripsy (ESWL). The aim of this study is to review how ESWL works, its indications and contraindications, predictive factors for success, and its complications. A search was conducted on the Pubmed ® database between January 1984 and October 2013 using "shock wave lithotripsy" and "stone" as key-words. Only articles with a high level of evidence, in English, and conducted in humans, such as clinical trials or review/ meta-analysis, were included. To optimize the search for the ESWL results, several technical factors including type of lithotripsy device, energy and frequency of pulses, coupling of the patient to the lithotriptor, location of the calculus, and type of anesthesia should be taken into consideration. Other factors related to the patient, stone size and density, skin to stone distance, anatomy of the excretory path, and kidney anomalies are also important. Antibiotic prophylaxis is not necessary, and routine double J stent placement before the procedure is not routinely recommended. Alpha-blockers, particularly tamsulosin, are useful for stones >10mm. Minor complications may occur following ESWL, which generally respond well to clinical interventions. The relationship between ESWL and hypertension/diabetes is not well established.

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“…Modern urologic techniques for stone removal, such as extracorporeal shock-wave lithotripsy or percutaneous nephrolithotomy, although generally safe, have some potential risk for renal damage [15]. Whether that risk is increased in patients with a single kidney is still unsettled [16,17,18,19,20]. …”

Section: Introductionmentioning

confidence: 99%

Trends in Kidney Donation among Kidney Stone Formers: A Survey of US Transplant Centers

et al. 2009

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Background: Living kidney donation is on the rise and acceptance criteria for potential donors are evolving to include more ‘complex’ patients such as kidney stone formers. Transplant centers are faced with sparse data on patient outcomes when evaluating potential donors who are stone formers; thus, attitudes and practice can differ greatly between centers. Methods: We conducted a survey of United States kidney transplant programs to assess current trends in the approach to dealing with stone formers who are evaluated for kidney donation. Results: Based on the survey results, there appears to be a tendency toward increased acceptance of donors with a history of kidney stones. 77% of responding centers allowed stone formers to donate. Nearly 40% of centers reported that their attitude towards accepting donors with kidney stones has changed over the last 5–10 years. Among these, the overwhelming majority reported that they were more likely to accept these donors. Conclusions: Such trends are likely based on organ need, as published patient outcomes and evidence-based guidelines are lacking for this unique group of patients. We propose the need for a study to formally evaluate the outcome of stone formers who donate a kidney in order to systematically examine whether appropriately selected stone formers can safely donate.

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Long-Term Effects of Extracorporeal Shock Wave Lithotripsy on Renal Function: Our Experience With 156 Patients With Solitary Kidney

Cited by 35 publications

References 17 publications

Urological Procedures in Urolithiasis and Their Association with Chronic Kidney Disease

Urological Procedures in Urolithiasis and Their Association with Chronic Kidney Disease

Extracorporeal shock wave lithotripsy in the treatment of renal and ureteral stones

Trends in Kidney Donation among Kidney Stone Formers: A Survey of US Transplant Centers

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