Renal morphology and function immediately after extracorporeal shock-wave lithotripsy

Kaude, J; Williams, Clyde M.; Millner, M R; Scott, Karen S.; Finlayson, Birdwell

doi:10.2214/ajr.145.2.305

Cited by 369 publications

(146 citation statements)

References 8 publications

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“…Clinically no changes in blood chemistry could be detected. Studying the acute effects of ESWL on renal function Kaude et al (1985) observed no significant reduction of total effective renal plasma flow using quantitative radionuclide renography. In the treated kidney, however, renal plasma flow decreased by more than 5% in 30% of all cases.…”

Section: Introductionmentioning

confidence: 99%

Effect of shock waves on suspended and immobilized L1210 cells

Brümmer

Brenner

Bräuner

et al. 1989

Ultrasound in Medicine & Biology

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Abstract--Ll210 mouse leukemia cells have been exposed to different doses of shock waves generated by underwater spark discharge at 18 kV in an experimental lithotripter (XL1, Dornier). Histological and flow cytometric investigations revealed severe damage and a LDso of about 420 shock waves when the cells were treated as suspensions. Cells immobilized in gelatine, however, were unaffected, indicating that secondary effects are responsible for the cellular damage. Possible mechanisms such as cavitation, jets, and shear forces are discussed.

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Section: Introductionmentioning

confidence: 99%

Effect of shock waves on suspended and immobilized L1210 cells

Brümmer

Brenner

Bräuner

et al. 1989

Ultrasound in Medicine & Biology

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“…In the first phase of its introduction, SWL seemed to cause no adverse side effects [1] but with time and the arrival of CT and MRI the risk for the kidney became apparent [3,4]. The rate of hematoma has been calculated to be around 0.5%.…”

Section: Historical Development Of Swlmentioning

confidence: 99%

The Future of SWL: A Global Perspective

Köhrmann¹

2007

AIP Conference Proceedings

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Abstract. The future relevance of shock wave lithotripsy (SWL) to the treatment of urinary stones has been questioned by some. This paper reviews recent developments with an aim to predict the level of usefulness of SWL for the future. The incidence of urolithiasis is increasing throughout the world, and existing metaphylaxis is not widely effective. This results in an increasing need for active stone removal. SWL was and is a well established treatment modality for urolithiasis in the upper urinary tract. For most stone situations there will remain a reasonable choice between SWL versus endoscopic procedures, and it is unlikely that endoscopic procedures will displace SWL completely in general practice. In conclusion, SWL will continue to play an established, if slightly reduced, role in stone treatment in the future.

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“…Physiological tests have revealed only minor, transient reductions of renal plasma flow in the treated kidney [45,82] and no clinically relevant changes in blood chemistry [17]. Furthermore, cytoplasmic enzymes have been reported to be only transiently released into the blood and urine of shock-wave-treated patients [46].…”

Section: Side Effectsmentioning

confidence: 99%

Biological effects of shock waves

1990

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Summary.Extracorporeal shock wave lithotripsy has become established worldwide as the method of choice for the treatment of nephrolithiasis and ureterolithiasis over the last 10 years. Although initial studies showed no damaging effects of the shock waves on organs and tissues, numerous recent reports have presented evidence for severe acute effects and chronic complications after shock wave treatment. The pathophysiological effects on kidneys and the histopathological effects on organs or tissues in man and animal, and also the effects on ceils in culture and tumors are sumarized. Suspended and immobilized cell cultures were used to characterize and quantify the efficacy of shock wave. Extended applications of shock waves and possible modifications to shock wave generators are discussed.A reproducible generation of shock waves in fluids was first reported by Eisenmenger [31,32], who described an electromagnetic arrangement using a flat solenoid and a metal membrane. About 20 years later, underwater sparkgap-induced shock waves were used for kidney stone disintegration [17], a procedure that has become clinical routine [30]. In the meantime, the third generation of lithotripters has been developed (Siemens Lithostar Plus, Dornier Compact, Storz Modulith). Most of them are equipped with electromagnetic shock-wave emitters (EMSE), but piezo-electric shock-wave sources (Piezolith 2500, Diasonics) with similar properties for stone fragmentation are also in clinical use. However, all commercially available shock-wave generators (spark gap, electromagnetic, piezo-electric) produce side effects that accompany stone disintegration in patients. Furthermore, their biological effects are described as injuries to organs or tissues in vivo that have been exposed to the focal area of shock waves and as damage to cells in culture that have been treated with shock waves. * Dedicated to Prof. Dr. Wolfgang Eisenmenger on the occasion of his 60th birthday Side effectsIn kidney-or gallstone treatment with shock waves, side effects are equivocally classified and certainly depend not only on the number and energy of the applied shock waves but also on the disposition of the patients. Petechial bleeding of the skin that can be observed macroscopically has been found in about 10% of patients [29]. Varying degrees of subcapsular fluid collection and hemorrhage have been detected using different methods [4,37,71].Most of the damage typically caused by shock-wave treatments is routinely observed and is not considered to represent severe pathological change, but the occurrence of perirenal hematoma has increased significantly in patients with pre-existing or poorly controllable hypertension [47]. Physiological tests have revealed only minor, transient reductions of renal plasma flow in the treated kidney [45,82] and no clinically relevant changes in blood chemistry [17]. Furthermore, cytoplasmic enzymes have been reported to be only transiently released into the blood and urine of shock-wave-treated patients [46]. Kishimoto et al. [46] ha...

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Renal morphology and function immediately after extracorporeal shock-wave lithotripsy

Cited by 369 publications

References 8 publications

Effect of shock waves on suspended and immobilized L1210 cells

Effect of shock waves on suspended and immobilized L1210 cells

The Future of SWL: A Global Perspective

Biological effects of shock waves

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