Creatinine kinase concentrations and electrocardiographic changes in extracorporeal shock-wave lithotripsy

Parr, Kirk; Lingeman, James E.; Jordan, Marion H.; Coury, Thomas A.

doi:10.1016/0090-4295(88)90447-5

Cited by 49 publications

(9 citation statements)

References 4 publications

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“…hock wave lithotripsy (SWL) remains the principal treatment for symptomatic renal calculi despite increasing awareness that SW damage the renal parenchyma (1)(2)(3)(4)(5). Clinical interest in treatment strategies aimed at minimizing the renal damage is high, and manufacturers of second-and thirdgeneration lithotripters have produced machines with higher power and smaller focal zones, ostensibly to enhance stone comminution and diminish injury to renal tissue.…”

mentioning

confidence: 99%

Prevention of Lithotripsy-Induced Renal Injury by Pretreating Kidneys with Low-Energy Shock Waves

Willis¹,

Evan²,

Connors³

et al. 2006

Journal of the American Society of Nephrology

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Lithotripsy shock waves (SW) to one renal pole damage that pole but protect the opposite pole from the damage inflicted by another, immediate application of SW. This study investigated whether the protection (1) occurs when the first treatment causes no injury, (2) is caused by SW or injury, (3) exhibits a threshold, and (4) occurs when the same pole receives both treatments. Six-to 7-wk-old anesthetized female pigs were studied. The following groups were studied: group 1 (n ‫؍‬ 4), 2000 SW at 12 kV to one pole and 2000 SW at 24 kV (standard) to the opposite pole; group 2 (n ‫؍‬ 6), same as group 1 except 500 12-kV SW pretreatment; group 3 (n ‫؍‬ 8), 500 12-kV, 2000 standard SW, all to the same pole; and group 4 (n ‫؍‬ 8), same as group 3 except 100 12-kV SW pretreatment. Mean ؎ SD lesion size in group 1, first pole treated, was 0.66 ؎ 0.82% of functional renal volume (FRV; P < 0.05 versus 5.22 ؎ 3.6% FRV with no pretreatment [NP]; 95% confidence interval [CI] ؊7.0 to ؊2.1) and 0.50 ؎ 0.68% FRV in the opposite pole after 2000 standard SW (P < 0.05 versus NP; 95% CI ؊9.4 to ؊0.08). Mean lesion size (first pole) in group 2 was 0.020 ؎ 0.028% FRV (P < 0.01 versus NP; 95% CI ؊9.2 to ؊1.2) and 0.43 ؎ 0.54% FRV in the opposite pole after 2000 standard SW (P < 0.05 versus NP; 95% CI ؊8.8 to ؊0.82). Same-pole SW (groups 3 and 4) also protected. Mean lesion sizes were 0.28 ؎ 0.33% (P < 0.01 versus NP; 95% CI ؊8.0 to ؊1.9) in group 3 and 0.39 ؎ 0.48% FRV (P < 0.01 versus NP; 95% CI ؊8.2 to ؊1.7) in group 4. It is concluded that the pretreatment protocol substantially limits the renal injury that normally is caused by SWL and occurs when the pretreatment and standard SW are applied to the same pole. The threshold for the protection may be <100 SW.

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confidence: 99%

Prevention of Lithotripsy-Induced Renal Injury by Pretreating Kidneys with Low-Energy Shock Waves

Willis¹,

Evan²,

Connors³

et al. 2006

Journal of the American Society of Nephrology

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“…serum CK [9][10][11], urine angioten sin-converting enzyme [ 12] and urine (5-galactosidase [ 12] increased significantly with ESWL for urolithiasis. Trinchicri et al [9], Kishimoto et al [ 10] and Parr et al [ 11 ] demonstrated a significant elevation of serum CK level by ESWL suggesting skeletal muscle injury, but no mention was made of urine CK concentrations. Trinchieri et al [9] demonstrated that a significant increase in serum LDH and NAG might be due to blood cell damage in cutaneous and renal circulation.…”

Section: Discussionmentioning

confidence: 99%

Effect of Extracorporeal Shockwave Lithotripsy for Urolithiasis on Concentrations of Creatine Kinase Isozymes in Patient Serum and Urine

et al. 1992

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To determine whether extracorporeal Shockwave lithotripsy (ESWL) for urolithiasis causes renal injury, we immunoassayed creatine kinase isozymes (CK-B and CK-M) in serum and urine from patients with renal stone (n = 21) and ureteral stone (n = 18) before and after (0, 2, and 24 h) ESWL. CK-B is generally present in renal tissue at relatively high concentrations, whereas CK-M is found at low concentrations. CK-B and CK-M levels were enhanced both in the serum and urine samples after ESWL in both groups of patients but CK-B levels return to almost normal very rapidly. Because CK-M, which is mainly localized in muscle tissue, also increased in both groups, the increased CK-B in serum after ESWL might be derived not only from kidney but also from muscle tissues which also contain a significant level of CK-B. These results suggest that significant tissue injury, including kidney and muscles, might be caused by ESWL treatment for urolithiasis but there is no long-term renal adverse effect, and that creatine kinase isozymes in serum and urine might be useful markers of tissue injury by such treatment.

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“…Earlier studies investigating various markers of ESWLrelated tissue injury [11][12][13][14] did not evaluate the differ ences between patients with renal stones and patients with ureteral stones. In addition, these studies evaluated parameters 12 h after ESWL or later.…”

Section: Resultsmentioning

confidence: 99%

S100a(0) Protein as a Marker for Tissue Damage Related to Extracorporeal Shock Wave Lithotripsy

Hasegawa

Kato²,

Takashi³

et al. 1993

Eur Urol

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Creatinine kinase concentrations and electrocardiographic changes in extracorporeal shock-wave lithotripsy

Cited by 49 publications

References 4 publications

Prevention of Lithotripsy-Induced Renal Injury by Pretreating Kidneys with Low-Energy Shock Waves

Prevention of Lithotripsy-Induced Renal Injury by Pretreating Kidneys with Low-Energy Shock Waves

Effect of Extracorporeal Shockwave Lithotripsy for Urolithiasis on Concentrations of Creatine Kinase Isozymes in Patient Serum and Urine

S100a(0) Protein as a Marker for Tissue Damage Related to Extracorporeal Shock Wave Lithotripsy

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