Prevalence of hypertension and diabetes after exposure to extracorporeal shock-wave lithotripsy in patients with renal calculi: a retrospective non-randomized data analysis

Abstract

PurposeTo evaluate the association of shock-wave lithotripsy (SWL) for kidney stones and hypertension or diabetes.MethodsPatients with urolithiasis treated by SWL were retrospectively identified. To assess whether shock-wave application to the kidney is associated with long-term adverse effects, patients after SWL for kidney stones were selected as the main group of interest. Patients treated with shock waves for distal ureter stones only were chosen as a comparison group. A questionnaire was sent to all patients to assess the prevalence of hypertension and diabetes. The Swiss Health Survey (SHS) dataset was used as an additional comparison group.ResultsAfter a median follow-up of 13.7 years, the odds ratio (OR) to report hypertension [OR 1.30 (95% CI 1.10–1.95)] or diabetes [OR 1.54 (95% CI 1.21–1.97)] was significantly higher in patients treated with SWL compared to the SHS dataset. In comparison with the kidney group, participants in the SHS had a significantly lower OR to report hypertension at follow-up [OR 0.79 (95% CI 0.65–0.95)], while the OR to report hypertension [1.16 (95% CI 0.79–1.70)] was not significantly different in the distal ureter group. For diabetes, a significantly lower [OR 0.60 (95% CI 0.46–0.78)] in the SHS group and a non-significantly lower [OR 0.68 (95% CI 0.38–1.22)] in the ureter group was noted compared to the kidney group.ConclusionCompared to the SHS data set SWL was in general associated with hypertension and diabetes. However, no clear difference between patients after SWL to the kidney compared to SWL to the distal ureter was seen and thus the data do not support a causal relationship.

Minimally invasive surgery for pediatric renal and ureteric stones: A therapeutic update

“…After ESWL, several complications, such as hematuria, renal hematoma, renal ureteral injury, renal colic, stone street formation, and urinary tract infection, may occur ( 27 ). The most frequent complication after ESWL treatment is ureteric obstruction induced by the stone fragments.…”

Comparison of laparoscopic ureterolithotomy and retrograde lithotripsy in the treatment of proximal ureteral stones

“…Дистанционная ударно-волновая литотрипсия (ДЛТ) в настоящее время применяется ограниченно, в связи с высоким уровнем осложнений. Особенно при наличии у пациента гипертонии и сахарного диабета [3]. Чрескожные пункционные доступы (ПНЛ) сопровождаются высоким риском значимой кровопотери и более длительным периодом реабилитации, в сравнении с уретероскопией [4].…”

The safety of extracorporeal shock wave lithotripsy: an undervalued issue

“…However, in more recent years, SWL renown has been challenged by the widespread diffusion of endourology; together, as time goes by, some concerns on long-term safety of SWL have been raised as well. Hypertension and diabetes are regarded as possible long-term drawbacks, and their risk after SWL has been addressed by a recent manuscript from Fankauser et al [2]. Authors reported in 2018 on the prevalence of hypertension and diabetes-assessed with a questionnaire mailed in 2015-in a series of 764 patients treated with SWL between 1993 and 2013.…”