Low-energy shock wave preconditioning reduces renal ischemic reperfusion injury caused by renal artery occlusion

Xue, Yuquan; Xu, Zhibin; Chen, Haiwen; Gan, Weimin; Chong, Tie

doi:10.1590/s0102-865020170070000006

Cited by 4 publications

(14 citation statements)

References 20 publications

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“…In rats, LI-ESWT reduced serum levels of kidney injury markers neutrophil gelatinase-associated lipocalin (NGAL) and KIM-1 and renal tissue injury after renal reperfusion injury. 39 In the present study, KIM-1 and clusterin decreased in the majority of patients after the first session of LI-ESWT but not overall statistically significantly. In animal studies, LI-ESWT reduced renal fibrosis following chronic proteinuric kidney disease 28 and after renal ischemic injury or reperfusion injury.…”

Section: Discussioncontrasting

confidence: 56%

Low-Intensity Shockwave Therapy (LI-ESWT) in Diabetic Kidney Disease: Results from an Open-Label Interventional Clinical Trial

Skov-Jeppesen¹,

Yderstræde²,

Jensen³

et al. 2021

IJNRD

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Purpose: Treatment with low-intensity shockwave therapy (LI-ESWT) is associated with angiogenesis and is suggested as a treatment for different types of vascular diseases. It was hypothesized that LI-ESWT improves the renal filtration barrier and halts the progression of GFR decline in diabetic kidney disease (DKD) potentially through VEGF and NO formation. We present the first data on LI-ESWT in human DKD. Methods: The study was designed as an interventional, prospective, one-arm, Phase 1 study. We investigated change in GFR and albuminuria in 28 patients with DKD treated with six sessions of LI-ESWT over three weeks. The patients were followed for six months. Urine excretion of kidney injury markers, vascular endothelial growth factor (VEGF) and nitric oxide metabolites (NOx) was studied after LI-ESWT. Results: There were no significant changes in GFR and albuminuria up to six months after LI-ESWT compared to baseline. Urine VEGF was transiently reduced one month after LI-ESWT, but there were no other significant changes in urine VEGF or NOx after LI-ESWT. Secondary analysis showed that NOx increased after LI-ESWT in patients who had low levels of NOx at baseline. Kidney injury marker trefoil factor 3 (TFF3) increased acutely after the first session of LI-ESWT indicating transient endothelial repair. Other markers of kidney injury were stable in relation to LI-ESWT. Conclusion: LI-ESWT treatment did not significantly improve kidney function and albumin excretion. It is concluded that LI-ESWT is not harmful. A randomized blinded study should be performed to clarify whether adjunctive treatment with LI-ESWT is superior to standard treatment of DKD.

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Section: Discussioncontrasting

confidence: 56%

Low-Intensity Shockwave Therapy (LI-ESWT) in Diabetic Kidney Disease: Results from an Open-Label Interventional Clinical Trial

Skov-Jeppesen¹,

Yderstræde²,

Jensen³

et al. 2021

IJNRD

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“…We identified a total of 12 eligible studies. Of these, 11 were animal studies [10][11][12][13][14][15][16][17][18][19][20] and one was a clinical study. 21,22 We found two preclinical animal studies 23,24 and two clinical studies 25,26 that were non-eligible since they were only published in abstract format.…”

Section: Resultsmentioning

confidence: 99%

“…Six of the animal studies used rats 10,12,[15][16][17]20 and five studies used pigs. 11,13,14,18,19 In the animal studies, different types of renal disease were induced by either N ω -nitro-L-arginine methyl ester (L-NAME) ingestion (hypertension, n=1), 10 streptozotocin injection (type 1 diabetes mellitus, n=1), 15 or renal artery occlusion/stenosis (hypoxic ischemia, n=9).…”

Section: Animal Studiesmentioning

confidence: 99%

“…11,13,14,18,19 In the animal studies, different types of renal disease were induced by either N ω -nitro-L-arginine methyl ester (L-NAME) ingestion (hypertension, n=1), 10 streptozotocin injection (type 1 diabetes mellitus, n=1), 15 or renal artery occlusion/stenosis (hypoxic ischemia, n=9). [11][12][13][14][16][17][18][19][20] The number of LI-ESWT treatment sessions varied from one single treatment 12,20 up to a maximum of 12 treatments. 10 The most common protocol for LI-ESWT treatment was two sessions per week for 3 weeks (n=5).…”

Section: Animal Studiesmentioning

confidence: 99%

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Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT) in Renal Diseases: A Review of Animal and Human Studies

Skov-Jeppesen¹,

Petersen²,

Yderstræde³

et al. 2023

IJNRD

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Background: Low-intensity extracorporeal shockwave therapy (LI-ESWT) has been suggested as a treatment for vascular diseases such as ischemic heart disease, diabetic foot ulcers, and erectile dysfunction. Primarily, LI-ESWT is known for its ability to stimulate angiogenesis and activation of stem cells in target tissues. Application of LI-ESWT in chronic progressive renal diseases is a novel area. The aim of the present review was to summarize available data on the effects of LI-ESWT used in the setting of renal diseases. Methods: We systematically searched PubMed, Medline, and Embase databases for relevant studies. Our review included the results from preclinical animal experiments and clinical research. Results: Eleven animal studies and one clinical study were included in the review. In the animal studies, LI-ESWT was used for the treatment of hypertensive nephropathy (n=1), diabetic nephropathy (n=1), or various types of ischemic renal injury (ie, artery occlusion, reperfusion injury) (n=9). The clinical study was conducted in a single-arm cohort as a Phase 1 study with patients having diabetic nephropathy. In animal studies, the application of LI-ESWT was associated with several effects: LI-ESWT led to increased VEGF and endothelial cell proliferation and improved vascularity and perfusion of the kidney tissue. LI-ESWT reduced renal inflammation and fibrosis. LI-ESWT caused only mild side effects in the clinical study, and, similarly, there were no signs of kidney injury after LI-ESWT in the animal studies. Conclusion: LI-ESWT, as a non-invasive treatment, reduces the pathological manifestations (inflammation, capillary rarefaction, fibrosis, decreased perfusion) associated with certain types of renal disease. The efficacy of renal LI-ESWT needs to be confirmed in randomized clinical trials.

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“…Group 2 was the LESW group: after anaesthesia with sodium pentobarbital (50 mg/kg, ip), the hair on the left flank was removed. The rats in a prone position, the LESW probe, which generated shock wave through the acceleration of a projectile inside the device (DolorClast, EMS, Swiss) and used the following parameters: 0.1 mJ/mm 2 energy flux density at 1 Hz for 200 impulses, 22 attached tightly to the left flank and a coupling agent was applied. Then, the left renal artery was separated without clamping.…”

Section: Methodsmentioning

confidence: 99%

Low‐energy shock wave pretreatment recruit circulating endothelial progenitor cells to attenuate renal ischaemia reperfusion injury

Liu

Dou

Zhou

et al. 2020

J Cellular Molecular Medi

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Low‐energy shock wave (LESW) has been recognized as a promising non‐invasive intervention to prevent the organs or tissues against ischaemia reperfusion injury (IRI), whereas its effect on kidney injury is rarely explored. To investigate the protective role of pretreatment with LESW on renal IRI in rats, animals were randomly divided into Sham, LESW, IRI and LESW + IRI groups. At 4, 12, 24 hours and 3 and 7 days after reperfusion, serum samples and renal tissues were harvested for performing the analysis of renal function, histopathology, immunohistochemistry, flow cytometry and Western blot, as well as enzyme‐linked immunosorbent assay. Moreover, circulating endothelial progenitor cells (EPCs) were isolated, labelled with fluorescent dye and injected by tail vein. The fluorescent signals of EPCs were detected using fluorescence microscope and in vivo imaging system to track the distribution of injected circulating EPCs. Results showed that pretreatment with LESW could significantly reduce kidney injury biomarkers, tubular damage, and cell apoptosis, and promote cell proliferation and vascularization in IRI kidneys. The renoprotective role of LESW pretreatment would be attributed to the remarkably increased EPCs in the treated kidneys, part of which were recruited from circulation through SDF‐1/CXCR7 pathway. In conclusion, pretreatment with LESW could increase the recruitment of circulating EPCs to attenuate and repair renal IRI.

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Low-energy shock wave preconditioning reduces renal ischemic reperfusion injury caused by renal artery occlusion

Cited by 4 publications

References 20 publications

Low-Intensity Shockwave Therapy (LI-ESWT) in Diabetic Kidney Disease: Results from an Open-Label Interventional Clinical Trial

Low-Intensity Shockwave Therapy (LI-ESWT) in Diabetic Kidney Disease: Results from an Open-Label Interventional Clinical Trial

Low-Intensity Extracorporeal Shockwave Therapy (LI-ESWT) in Renal Diseases: A Review of Animal and Human Studies

Low‐energy shock wave pretreatment recruit circulating endothelial progenitor cells to attenuate renal ischaemia reperfusion injury

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