Early observations of the effect of extracorporeal shockwave lithotripsy on blood pressure: a prospective randomized control clinical trial

Elves, A.; Tilling, Kate; Menezes, Pravin; Wills, M. I.; Rao, P. N.; Feneley, R. C. L.

doi:10.1046/j.1464-410x.2000.00571.x

Cited by 36 publications

(22 citation statements)

References 24 publications

(32 reference statements)

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“…The prevalence of HBP among patients with nephrolithiasis varies from 19.4% to 71.7% (11,14,35). HBP is poorly studied in cystinuric patients.…”

Section: Discussionmentioning

confidence: 99%

CKD and Its Risk Factors among Patients with Cystinuria

Prot-Bertoye¹,

Lebbah²,

Daudon³

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Cystinuria is an autosomal recessive disorder affecting renal cystine reabsorption; it causes 1% and 8% of stones in adults and children, respectively. This study aimed to determine epidemiologic and clinical characteristics as well as comorbidities among cystinuric patients, focusing on CKD and high BP.Design, setting, participants, & measurements This retrospective study was conducted in France, and involved 47 adult and pediatric nephrology and urology centers from April 2010 to January 2012. Data were collected from 442 cystinuric patients.Results Median age at onset of symptoms was 16.7 (minimum to maximum, 0.3-72.1) years and median diagnosis delay was 1.3 (0-45.7) years. Urinary alkalinization and cystine-binding thiol were prescribed for 88.8% and 52.2% of patients, respectively, and 81.8% had at least one urological procedure. Five patients (1.1%, n=4 men) had to be treated by dialysis at a median age of 35.0 years (11.8-70.7). Among the 314 patients aged $16 years, using the last available plasma creatinine, 22.5% had an eGFR$90 ml/min per 1.73 m 2 (calculated by the Modification of Diet in Renal Disease equation), whereas 50.6%, 15.6%, 7.6%, 2.9%, and 0.6% had an eGFR of 60-89, 45-59, 30-44, 15-29, and ,15, respectively. Among these 314 patients, 28.6% had high BP. In multivariate analysis, CKD was associated with age (odds ratio, 1.05 [95% confidence interval, 1.03 to 1.07]; P,0.001), hypertension (3.30 [1.54 to 7.10]; P=0.002), and severe damage of renal parenchyma defined as a past history of partial or total nephrectomy, a solitary congenital kidney, or at least one kidney with a size ,10 cm in patients aged $16 years (4.39 [2.00 to 9.62]; P,0.001), whereas hypertension was associated with age (1.06 [1.04 to 1.08]; P,0.001), male sex (2.3 [1.3 to 4.1]; P=0.003), and an eGFR,60 ml/min per 1.73 m 2 (2.7 [1.5 to 5.1]; P=0.001).Conclusions CKD and high BP occur frequently in patients with cystinuria and should be routinely screened.

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“…The prevalence of HBP among patients with nephrolithiasis varies from 19.4% to 71.7% (11,14,35). HBP is poorly studied in cystinuric patients.…”

Section: Discussionmentioning

confidence: 99%

CKD and Its Risk Factors among Patients with Cystinuria

Prot-Bertoye¹,

Lebbah²,

Daudon³

et al. 2015

Clinical Journal of the American Society of Nephrology

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“…In particular, a number of uncontrolled and/or retrospective early reports suggested that ESWL might cause hypertension [19][20][21]. On the other hand, these postulated deleterious effects have not been confirmed by others [22][23][24][25] and two recent independent randomized controlled trials in the USA [26] and in the UK [27] have shown that there is no detectable increase in the incidence of hypertension following ESWL. In our study, patients who had received ESWL did not have higher blood pressure than those who had not received it, so any difference in blood pressure between stone-formers and controls cannot be ascribed to ESWL treatment.…”

Section: Discussionmentioning

confidence: 99%

Calcium Urolithiasis, Blood Pressure and Salt Intake

et al. 2003

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Objectives: To determine whether stone-formers have higher BP than controls drawn from the general population and matched for age, sex and ethnic origin and to compare the relationship between sodium and calcium excretion in the two groups. Patients and methods: Thirty-six patients [mean (AEstandard deviation, SD) = 49.0 AE 11.7 years; range 27-70 years] with kidney or ureteric stones and 108 controls (mean age of 49.6 AE 6.8 years; range 39-61 years), matched for gender, ethnic origin and age group were studied. Patients and controls underwent physical measurements, a venous blood sample and they were asked to collect a 24-h urine sample for sodium, potassium, calcium and creatinine. Results: Stoneformers were significantly heavier and had higher BP than age-, sex-and ethnic-matched population controls. Whilst the difference in systolic BP was independent of the difference in body mass index [16.8 mmHg (7.2-26.4 mmHg), p = 0.001), the difference in diastolic BP was attenuated after adjustment for body mass [1.8 (À3.4 to 7.1), p = 0.49]. Stone-formers passed less urine than controls [À438 ml/day (95% CI À852 to À25), p = 0.038]. They had higher urinary calcium than controls [3.7 mmol/day (2.8-4.6 mmol/day), p < 0.001], even when expressed as ratio to creatinine [0.20 (0.11-0.29), p < 0.001]. Sodium excretion was positively associated with urinary calcium in both stone-formers and in controls. The slopes were comparable (0.92 vs 0.98 mmol Ca/100 mmol Na) so that for any level of sodium excretion (or salt intake), stone-formers had a higher calcium excretion than controls. Conclusions: In stone-formers, the BP is higher than in controls. Stone-formers excrete more calcium than controls do. In stone-formers and controls, the relationship between urinary sodium and calcium is similar. Since this relationship results from an effect of sodium on calcium, a reduction in salt intake may be a useful method of reducing urinary calcium excretion in stone-formers. However, the "relative" hypercalciuria seen in stone-formers is independent of salt intake and may well reflect an underlying genetic predisposition.

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“…[7,8] The pain is of varying degrees (mild, moderate and severe). [9,10] Post SWL pain ranges from 22.5% to 74%. [11,12] It can be assessed according to the visual analog scale (VAS) which is a patient self-report on a scale of 0-10.…”

Section: Introductionmentioning

confidence: 99%

“…[13] It is usually treated on outpatient basis by the administration of analgesics in the form of NSAID or narcotics, and only few patients require hospitalization. [9,14,15] Hypertension is another complication of SWL. [9] According to the WHO, hypertension is defined as having systolic blood pressure (BP) above 140 mmHg or diastolic BP above 90 mmHg.…”

Section: Introductionmentioning

confidence: 99%

The effect of shockwave lithotripsy on blood pressure, patients’ tolerance to pain and perirenal hematoma in renal stone patients

Aghaways

Ghareeb²,

Fryad³

et al. 2015

JER

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Purpose: To assess the effect of extracorporeal shockwave lithotripsy (SWL) on blood pressure, patients' tolerance to pain and perirenal hematoma in patients with renal stones. Patients and methods: One hundred eighty nine patients between 2007-2009 underwent SWL procedures at 4.5 and 5.5 KV with shockwaves of up to 4,000 and 5,000 shockwaves, they were followed up for post procedure pain, hypertension and perirenal hematoma. For statistical analysis, chi square test was used. Results: One hundred fifty three (81%) patients developed post procedure pain. The degree of pain was of mild that relieved by analgesia to severe that required hospitalization, increasing energy level did not increase the chance of post SWL pain while the larger stones caused more post SWL pain (p = .003). Fifteen patients (7.9%) developed post SWL hypertension, female patients and age more than 50 years found to increase the risk of post SWL hypertension. Post SWL hypertension is not affected by increasing energy level and number of shockwaves. Only one patient (0.52%) developed post SWL perirenal hematoma. Conclusion: SWL has a high incidence of post SWL pain. Females and age above 50 years are more prone to develop post SWL hypertension. However the number of shockwaves and energy level did not increase the risk of developing post SWL hypertension. Perirenal hematoma is a rare complication of SWL.

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Early observations of the effect of extracorporeal shockwave lithotripsy on blood pressure: a prospective randomized control clinical trial

Abstract: Objective To determine, in a randomized controlled clinical trial, the effect of extracorporeal shock wave lithotripsy (ESWL) on blood pressure.

Cited by 36 publications

References 24 publications

CKD and Its Risk Factors among Patients with Cystinuria

CKD and Its Risk Factors among Patients with Cystinuria

Calcium Urolithiasis, Blood Pressure and Salt Intake

The effect of shockwave lithotripsy on blood pressure, patients’ tolerance to pain and perirenal hematoma in renal stone patients

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