MP18-16 IMPACT OF SHOCK WAVE LITHOTRIPSY ON RENAL FUNCTIONстатья из журнала
Аннотация: You have accessJournal of UrologyStone Disease: Therapy II1 Apr 2014MP18-16 IMPACT OF SHOCK WAVE LITHOTRIPSY ON RENAL FUNCTION Stephanie Tam, Daniela Ghiculete, Tarek Alzahrani, R.J.D'A. Honey, and Kenneth T. Pace Stephanie TamStephanie Tam More articles by this author , Daniela GhiculeteDaniela Ghiculete More articles by this author , Tarek AlzahraniTarek Alzahrani More articles by this author , R.J.D'A. HoneyR.J.D'A. Honey More articles by this author , and Kenneth T. PaceKenneth T. Pace More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.778AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Shock wave lithotripsy (SWL) has been a standard treatment option for nephrolithiasis for many years. The safety and efficacy of SWL is well documented, however data on the long-term impact of SWL on renal function is lacking. This is particularly important as epidemiologic data suggests that chronic kidney disease (CKD) is increasingly common in stone patients. Our objective was to evaluate change (if any) in renal function among patients who underwent SWL treatments, and to assess any cumulative effect of repeated treatments on renal function. METHODS We retrospectively analyzed 324 patients who had at least one SWL treatment and two or more 24h urine collections at St. Michael’s Hospital from 2002-2013. The patients were divided into 3 groups based on number of SWL treatments: 1 treatment, 2-5 treatments, and >5 treatments. The estimated glomerular filtration rate (eGFR), as calculated using the MDRD formula, was used as a marker of overall renal function. For each patient, we determined the baseline eGFR values and compared them to values from a 24h urine collection obtained after at least 1 SWL. Linear regression analysis was used to compare the change in renal function before and after SWL in each of the 3 groups, and logistic regression analysis was used to assess if there was any change in CKD class following SWL. RESULTS There was a mean of 5 years between 24h urine collections, and patients were a mean of 49yo at first treatment; 60% were male. 90.1% of patients had normal to mild CKD at both baseline and after SWL (90.1% vs. 85.8%, respectively). 16% of patients underwent 1 SWL treatment, 69% underwent 2-5, and 15% underwent >5. There was no significant difference in baseline renal function in patients requiring more treatments (82.7 vs. 84.9 vs. 81.8, p=0.55). In multivariate analysis, age was the only predictor of final eGFR (p=0.01); there was no difference in change in eGFR among patients treated with a single SWL vs. those with multiple treatments (p=0.26). While CKD class deteriorated in 8.7% of patients, it improved in 4.3%, and number of SWL treatments did not impact change in CKD class (p=0.571). CONCLUSIONS While some (especially older) patients demonstrated a small deterioration in renal function over time, the number of SWL treatments did not correlate with this change. This suggests that even multiple SWL treatments have negligible impact on global renal function. Larger scale and prospective or epidemiologic studies that better account for other confounders should be performed to confirm this finding. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e209 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Stephanie Tam More articles by this author Daniela Ghiculete More articles by this author Tarek Alzahrani More articles by this author R.J.D'A. Honey More articles by this author Kenneth T. Pace More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Год издания: 2014
Издательство: Lippincott Williams & Wilkins
Источник: The Journal of Urology
Ключевые слова: Kidney Stones and Urolithiasis Treatments
Открытый доступ: closed
Том: 191
Выпуск: 4S