Shock Wave Lithotripsy Not Associated With Development of Diabetes Mellitus at 6 Years of Follow-up

Makhlouf, Antoine A.; Thorner, Daniel; Ugarte, Roland; Monga, Manoj

doi:10.1016/j.urology.2008.07.066

Cited by 28 publications

(20 citation statements)

References 6 publications

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“…More recently, the same group of investigators failed to demonstrate an association between SWL and the onset of T2D in a population-based cohort of 423 adult patients during a mean follow up of ~9 years. 27 Others have also reported no change in the incidence of T2D in adult patients whose kidney stones were treated with SWs using the HM3 or Medstone STS lithotripter, with follow ups that were of a 6 year, 12 17 year 11 or 20 year duration. 28 A group of 70 pediatric patients (mean age of 6.5 years old) with renal stones were treated with single or multiple SWL sessions using the Doli S or MFL 5000 lithotripters, and had normal blood sugar values over a mean follow up period of ~5 years—that is, no patient developed T2D after SWL.…”

Section: Discussionmentioning

confidence: 99%

“…10 Shortly after the publication of the Mayo Clinic report, there were 2 additional retrospective follow up studies of 17 years or less of stone patients treated with SWL that did not show a higher incidence of T2D. 11,12 With this background of clinical information at hand, we embarked on an animal study to address the issue of whether SWL treatment could increase the risk of developing T2D. We used the Ossabaw miniature swine model that develops similar features of human metabolic syndrome (MetS) 13,14 —a cluster of factors that includes obesity, insulin resistance, impaired glucose tolerance, dyslipidemia and hypertension—and examined whether SWL of the kidney exacerbates the severity of MetS, i.e.…”

Section: Introductionmentioning

confidence: 99%

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Shock Wave Lithotripsy Targeting of the Kidney and Pancreas Does Not Increase the Severity of Metabolic Syndrome in a Porcine Model

et al. 2014

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Purpose To determine whether shock wave lithotripsy (SWL) treatment of the kidney of metabolic syndrome (MetS) pigs worsens glucose tolerance or increases the risk of developing diabetes mellitus. Materials and Methods Nine-month-old female Ossabaw miniature pigs were fed a hypercaloric atherogenic diet to induce MetS. At 15 months of age, pigs were treated with 2000 SWs or 4000 SWs (24 kV at 120 SWs/min) using the unmodified Dornier HM3 lithotripter. SWs were targeted to the upper pole calyx of the left kidney so as to model treatment that would also expose the tail of the pancreas to SWs. Intravenous glucose tolerance tests (IVGTTs) were performed on conscious, fasting pigs before SWL and at 1 month and 2 months post-SWL with blood samples taken for glucose and insulin measurement. Results Pigs fed the hypercaloric atherogenic diet were obese, dyslipidemic, insulin resistant and glucose intolerant—consistent with the development of MetS. Assessment of insulin resistance, glucose tolerance and pancreatic beta cell function from fasting plasma glucose and insulin levels, and the glucose and insulin response profile to IVGTTs, were similar before and after SWL. Conclusions The MetS status of SWL treated pigs was unchanged 2 months following treatment of the kidney with 2000 high-amplitude SWs or overtreatment with 4000 high-amplitude SWs. These findings do not support a single SWL treatment of the kidney as a risk factor for the onset of diabetes mellitus.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Shock Wave Lithotripsy Targeting of the Kidney and Pancreas Does Not Increase the Severity of Metabolic Syndrome in a Porcine Model

et al. 2014

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“…In relation to the development of diabetes, a study with an identical design to the one mentioned above and with 1,869 patients submitted to ESWL did not find an increased incidence of diabetes in such patients compared to controls matched for age, sex and body mass index (5.2 versus 5.8%; p=0.47). 38 A study of 5,287 patients with calculi and without diabetes monitored for an average of 8.7 years found no association between ESWL and the appearance of diabetes in both univariate and multivariate analyses, including age, sex and obesity (hazard ratio = 0.92; 95% CI 0.71-1.18). 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).…”

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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“…Despite known factors predicting survival, our understanding of natural history of PC is far from complete. This is partly because the disease is heterogeneous in morphology, clinical behaviour and geographical variation2.…”

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confidence: 99%

Predictors for progression of metastatic prostate cancer to castration-resistant prostate cancer in Indians

Sureka

Maheshwari²,

Agnihotri

et al. 2016

Indian Journal of Medical Research

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Background & objectives:There is lack of data on natural history and progression of prostate cancer (PC) which have implications in the management of the disease. We undertook this retrospective study to analyze factors predicting progression of metastatic PC to castration-resistant prostate cancer (CRPC) in Indian men.Methods:Complete records of 223 of the 489 patients with metastatic PC were obtained from computerized data based system in a tertiary care hospital in north India between January 2000 to June 2012. Patients with follow up of < 6 months were excluded. Age (≤ and > 65 yr), baseline PSA (< and ≥ 50 ng/ml), bone scan and Gleason score (≤7 and >7) were recorded. Extent of bone disease (EOD) was stratified according to the number of bone lesions i.e., < 5, 5-10, > 10. CRPC was defined as two consecutive PSA rise of > 50 per cent from nadir or an absolute value of > 5 ng/ml.Results:Mean age of patients was 61.5 ± 12.45 yr and their PSA level was 325.6 ± 631.35 ng/dl. Of the 223 patients, 193 (86%) progressed to CRPC at median time of 10.7 (4-124) months. Median follow up was 24 (6-137) months. On univariate and multivariate analyses EOD on bone scan was found to be a significant predictor (P=0.006) for time to CRPC. Median time to CRPC was 10 months (CI 95%, 7.5-12.48) with >10 lesions or super scan versus 16 months (CI 95%, 10.3-21.6) with <10 bone lesion (P=0.01). Ninety (46.6 %) patients of CRPC died with median time to death from time of CRPC 21 (10-120) months.Interpretation & conclusions:Median time for progression of metastatic PC to CRPC ranged from 10-16 months depending on the extent of the bone involvement. In Indians, the aggressive course of advanced prostate cancer warrants further clinical trials to explore the need for additional treatment along with initial castration.

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Shock Wave Lithotripsy Not Associated With Development of Diabetes Mellitus at 6 Years of Follow-up

Cited by 28 publications

References 6 publications

Shock Wave Lithotripsy Targeting of the Kidney and Pancreas Does Not Increase the Severity of Metabolic Syndrome in a Porcine Model

Shock Wave Lithotripsy Targeting of the Kidney and Pancreas Does Not Increase the Severity of Metabolic Syndrome in a Porcine Model

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

Predictors for progression of metastatic prostate cancer to castration-resistant prostate cancer in Indians

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