Age-Related Changes in Resistive Index Following Extracorporeal Shock Wave Lithotripsy

Knapp, Rudolf; Frauscher, Ferdinand; Helweg, Gernot; Nedden, Dieter zur; Strasser, Hannes; Janetschek, Günter; Bartsch, Georg

doi:10.1016/s0022-5347(01)66942-8

Cited by 38 publications

(32 citation statements)

References 21 publications

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“…Currently, an increase in RI values is expected after SWL therapy, which has been confirmed in many studies, though there are a few exceptions [11,18]. In the present study, we found higher RI values after SWL sessions in patients in both groups, comparable to that reported previously in literature.…”

Section: Discussionsupporting

confidence: 91%

“…Measurement of the renal arterial resistive index (RI) of the kidney is a recently applied successful radiological tool that can reveal the resistance of intrarenal arteries, indirectly demonstrating effective renal blood flow [8][9][10]. Recently, it was shown that shock waves may decrease renal blood flow, which can lead to transient impairments in renal function after SWL [11].…”

Section: Introductionmentioning

confidence: 99%

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The Daily Resistive Index measurement useful tool in the estimation of the optimal time interval between two Shock Wave Lithotripsy sessions.

et al. 2015

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Objective: To monitor the impact of Shock Wave Lithotripsy (SWL) on the renal resisive index (RI) and to investigate the potential of the RI measurement for the estimation of the optimal duration between 2 SWL sessions. Material and methods: Thirty patients with single pelvis renalis stone were included. Participitants were grouped according to their age as group1 (<40 years, mean age 36.2±3.9 years) and group 2 (≥40 years, mean age 55.4±6.5 years). RI measurement was performed in of all patients prior to SWL. After SWL, RI was monitored daily until RI returned to their pre-SWL values. Results: The mean stone size was 2 8.97±3.62 in group 1 and 10.08±4.67 mm in group 2 (p=0.077). Following SWL RI value of both goups increased and higher RI value was measured at 24 th hour as compared with their pre-SWL values (p<0.001). In day 2 RI of the groups declined, but the differences were still statistically different from their pre-SWL RI values (p<0.001). However, on the third day, RI of group 1 was close to their pre-SWL level (p=0.143). But, in group 2, RI value returned to their pre-SWL limits on day 4 (p=0.229). Conclusions: RI measurement gives important data regarding SWL related acute renal trauma and should be used as an US marker for recovery after SWL.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The Daily Resistive Index measurement useful tool in the estimation of the optimal time interval between two Shock Wave Lithotripsy sessions.

et al. 2015

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“…Among these, one prospective study showed age as a significant risk factor, with an increase in intrarenal resistive index in patients 60 years of age and older 62 . Other studies as well have reported an increase in hypertension among older lithotripsy patients 66 . It appears that transient hypertension can result from formation of subcapsular hematomas 52 .…”

Section: The Potential For Long-term Adverse Effects Due To Swl: Hypementioning

confidence: 87%

“…A number of clinical studies have suggested that new-onset hypertension is a potential longterm consequence of SWL 1,[62][63][64][65][66][67] . Among these, one prospective study showed age as a significant risk factor, with an increase in intrarenal resistive index in patients 60 years of age and older 62 .…”

Section: The Potential For Long-term Adverse Effects Due To Swl: Hypementioning

confidence: 99%

The Acute and Long-Term Adverse Effects of Shock Wave Lithotripsy

McAteer

Evan

2008

Seminars in Nephrology

152

105

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Shock wave lithotripsy (SWL) has proven to be a highly effective treatment for the removal of kidney stones. Shock waves (SW's) can be used to break most stone types, and because lithotripsy is the only non-invasive treatment for urinary stones SWL is particularly attractive. On the downside SWL can cause vascular trauma to the kidney and surrounding organs. This acute SW damage can be severe, can lead to scarring with a permanent loss of functional renal volume, and has been linked to potentially serious long-term adverse effects. A recent retrospective study linking lithotripsy to the development of diabetes mellitus has further focused attention on the possibility that SWL may lead to life-altering chronic effects 1 . Thus, it appears that what was once considered to be an entirely safe means to eliminate renal stones can elicit potentially severe unintended consequences. The purpose of this review is to put these findings in perspective. The goal is to explain the factors that influence the severity of SWL injury, update current understanding of the long-term consequences of SW damage, describe the physical mechanisms thought to cause SWL injury, and introduce treatment protocols to improve stone breakage and reduce tissue damage. Keywordslithotripsy; shock waves; urinary stones; kidney; injury; vascular trauma The Advantages and Limitations of SWLShock wave lithotripsy employs high energy acoustic pulses (shock waves) generated outside the body to break stones within the kidney and ureter. As such SWL is the only non-invasive method available to remove stones. In the early years following its introduction SWL was considered an option for the treatment of virtually any stone type in any anatomical location. Urologists soon learned, however, that the urinary tract has a limited ability to clear stone fragments and that ureteral obstruction could occur if the mass of stone debris was too high. As such SWL is now used to treat otherwise uncomplicated solitary stones, or a combined stone burden of less than 2 cm (on KUB), located in the upper urinary tract (renal pelvis or proximal ureter) 2 . Not all mineral types respond well to SW's. Some calcium oxalate monohydrate stones, brushite stones and a sub-type of cystine can be highly SW-resistant 3. A noteworthy drawback of SWL is that in many cases stone fragments left behind can serve as foci for the development of new stones 4. As such, stone free rates are lower and stone Please address correspondence to: James A. McAteer, Ph.D., Professor, Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, mcateer@anatomy.iupui.edu, (FAX) 317-278-2040. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process ...

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“…They indicated that the relationship was linear. 26 It can be justified as follows: (a) applying different lithoclast sets in these three studies, (b) the difference found between these three studies considering treatment method, number, and power of shocks, and (c) different measurement times of vascular RI in these studies. Nazaroglu et al demonstrated that there was no meaningful relationship between the applied energy and increase of vascular RI.…”

Section: Discussionmentioning

confidence: 99%

Renal Vascular Doppler Resistance after Extracorporeal Shock Wave Lithotripsy

et al. 2013

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Objectives: Extracorporeal shock wave lithotripsy (ESWL) is mainly an alternative for other therapeutic methods such as surgery and endourology to treat urinary tract calculus. Although it is safe and effective, it has undesirable effects on renal function. Diagnostic techniques such as color Doppler ultrasonography create a new attitude toward renal function. The aim of this study was to evaluate renal vascular resistance change before and after extracorporeal shock wave lithotripsy. Methods: During the present study, vascular resistive index (RI) of renal intralobar artery was measured before, 30 min, and 1 week after ESWL using Doppler ultrasonography. Results: Thirty minutes after ESWL, RI was significantly increased from primary value of 0.62 AE 0.05 to 0.66 AE 0.06 (p ¼ 0.0001). There was no correlation between increase of RI and patients' age. Following up the patients revealed that mean RI did not return to pretreatment level after 1 week (p < 0.05). The RI level in the old patients (3 patients who were 60 years or older) was higher than that of the younger ones (19 patients who were younger than 60 years) after 1 week (0.76 AE 0.05 vs. 0.64 AE 0.06). There was no meaningful relationship between ESWL voltage or number of shocks and RI variation before and after ESWL. Conclusion: Following ESWL, patients are at risk of renal tissue damage due to increase of primary RI level. Measuring RI variations using ultrasound techniques after ESWL may provide helpful information to clinical detection of renal tissue damage.

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Age-Related Changes in Resistive Index Following Extracorporeal Shock Wave Lithotripsy

Abstract: Elderly patients have a higher risk of post-ESWL renal tissue damage.

Cited by 38 publications

References 21 publications

The Daily Resistive Index measurement useful tool in the estimation of the optimal time interval between two Shock Wave Lithotripsy sessions.

The Daily Resistive Index measurement useful tool in the estimation of the optimal time interval between two Shock Wave Lithotripsy sessions.

The Acute and Long-Term Adverse Effects of Shock Wave Lithotripsy

Renal Vascular Doppler Resistance after Extracorporeal Shock Wave Lithotripsy

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