Abstract:
Both clinical and experimental reports clearly show that shock wave lithotripsy (SWL) causes acute renal effects in a majority, if not all, treated kidneys. SWL-induced acute renal damage results in injury to the nephron, microvasculature, and surrounding interstitium. What has not been established is a set of objectively determined criteria for the safe clinical use of SWL. To accomplish this goal, animal experimentation has been conducted so that the time course and severity of acute alterations could be followed in a model that closely mimics human kidney. We chose the pig to determine the effect (or risk) of the size of the kidney and/or the number of treatments during the same session on the severity of the change in renal hemodynamics. Our data shows the greatest degree of change was induced in the kidney with the least mass and receiving multiple treatments. [Work supported by NIH.]