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- Title
Renal Disease Potentiates the Injury Caused by SWL.
- Authors
EVAN, ANDREW P.; CONNORS, BRET A.; PENNINGTON, DEBRA J.; BLOMGREN, PHILIP M.; LINGEMAN, JAMES E.; FINEBERG, NAOMI S.; WILLIS, LYNN R.
- Abstract
Purpose: The present study tested the hypothesis that renal disease potentiates the structural/functional changes induced by a clinical dose of shockwaves. Materials and Methods: Experimental pyelonephritis was induced in 6- to 8-week-old pigs before treatment with 2000 shocks at 24 kV. These pigs were divided into two groups according to whether they were infected with a highly virulent (Group 1) or less virulent (Group 2) inoculation of E. coli. All animals were imaged by MR prior to SWL as a means of documenting the extent of pyelonephritis and immediately after SWL to examine the lesion produced by the shockwaves. The glomerular filtration rate (GFR), renal plasma flow (RPF) and para-aminohippurate (PAH) extraction were determined bilaterally on day 30 (Group 1) or day 80 (Group 2). Results: In group 2, urine flow and sodium excretion were reduced by 50% from baseline in the shocked kidneys at both 1 and 4 hours post-SWL. A sustained reduction in RPF through 4 hours post-SWL was noted in the shocked kidneys in Group 1, but RPF was significantly reduced only at the 1-hour determination in Group 2. Large, consistent reductions in GFR were evident at 1 and 4 hours post-SWL in shocked and unshocked kidneys of Group 2 and in the shocked kidneys of Group 1. No significant changes were noted in PAH extraction. Conclusion: Acute pyelonephritis exaggerated the effect of a clinical dose of shockwaves on renal hemodynamics. This effect suggests that renal disease may be risk factor for SWL-induced injury.
- Publication
Journal of Endourology, 1999, Vol 13, Issue 9, p619
- ISSN
0892-7790
- Publication type
Article
- DOI
10.1089/end.1999.13.619