Side Effects of Extracorporeal Shock-Wave Exposure in Patients
Treated by Extracorporeal Shock-Wave Lithotripsy for Upper
Urinary Tract Stone

Kishimoto, Toshifumi; Yamamoto, Keisuke; Sugimoto, Toshikado; Yoshihara, Hidetaka; Maekawa, Masanobu

doi:10.1159/000472644

Cited by 103 publications

(43 citation statements)

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“…A decrease in renal effective plasma How by Hippuran renal scans and renal blood flow by 99mTc-DTPA has also been observed [9,12]. In addition, a significant increase in tubular-cell-escaped enzymes in the urine immediately after ESWL has been reported [7,[13][14][15]. However, these changes have been shown to be transient, and in our reports [12,13], values of tubularcell-escaped enzymes in the urine decreased within 1 week, decreased renal blood flow was restored within 1 month, and even remarkable subcapsular hematomas dissolved within 3 months.…”

Section: Discussionmentioning

confidence: 88%

Examination of Aggravating Factors of Urinary Excretion of N-Acetyl-Beta-<i>D</i>-Glucosaminidase after Extracorporeal Shock Wave Lithotripsy

Sakamoto

Kishimoto

Nakatani

et al. 1991

Nephron

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We measured urinary N-acetyl-β-D-glucosaminidase (NAG) excretion before and after extracorporeal shock wave lithotripsy (ESWL) with a view to study the underlying factors which aggravate renal impairment immediately after ESWL. The factors associated with the significant elevation of urinary NAG after ESWL included female sex, a previous history of ESWL, and urinary tract infection (UTI). By studying the backgrounds of these factors, we found that both the female group and the group with a previous history of ESWL contained significantly more patients with UTI. These findings indicate that UTI may be one of the risk factors which aggravate renal damage immediately after ESWL, and that careful management is necessary in the ESWL treatment of urinary tract stones with UTI.

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Section: Discussionmentioning

confidence: 88%

Examination of Aggravating Factors of Urinary Excretion of N-Acetyl-Beta-<i>D</i>-Glucosaminidase after Extracorporeal Shock Wave Lithotripsy

Sakamoto

Kishimoto

Nakatani

et al. 1991

Nephron

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“…Physiological tests have revealed only minor, transient reductions of renal plasma flow in the treated kidney [45,82] and no clinically relevant changes in blood chemistry [17]. Furthermore, cytoplasmic enzymes have been reported to be only transiently released into the blood and urine of shock-wave-treated patients [46]. Kishimoto et al [46] have also described an increase in creatine phosphokinase and myoglobin levels in blood on the 1st postoperative day.…”

Section: Side Effectsmentioning

confidence: 99%

“…Furthermore, cytoplasmic enzymes have been reported to be only transiently released into the blood and urine of shock-wave-treated patients [46]. Kishimoto et al [46] have also described an increase in creatine phosphokinase and myoglobin levels in blood on the 1st postoperative day. Their results indicate the occurrence of hemolysis, which may be due to hematomas, and myolysis, which could represent either direct damage induced by shock waves or a secondary effect caused by vasoconstriction.…”

Section: Side Effectsmentioning

confidence: 99%

Biological effects of shock waves

1990

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Summary.Extracorporeal shock wave lithotripsy has become established worldwide as the method of choice for the treatment of nephrolithiasis and ureterolithiasis over the last 10 years. Although initial studies showed no damaging effects of the shock waves on organs and tissues, numerous recent reports have presented evidence for severe acute effects and chronic complications after shock wave treatment. The pathophysiological effects on kidneys and the histopathological effects on organs or tissues in man and animal, and also the effects on ceils in culture and tumors are sumarized. Suspended and immobilized cell cultures were used to characterize and quantify the efficacy of shock wave. Extended applications of shock waves and possible modifications to shock wave generators are discussed.A reproducible generation of shock waves in fluids was first reported by Eisenmenger [31,32], who described an electromagnetic arrangement using a flat solenoid and a metal membrane. About 20 years later, underwater sparkgap-induced shock waves were used for kidney stone disintegration [17], a procedure that has become clinical routine [30]. In the meantime, the third generation of lithotripters has been developed (Siemens Lithostar Plus, Dornier Compact, Storz Modulith). Most of them are equipped with electromagnetic shock-wave emitters (EMSE), but piezo-electric shock-wave sources (Piezolith 2500, Diasonics) with similar properties for stone fragmentation are also in clinical use. However, all commercially available shock-wave generators (spark gap, electromagnetic, piezo-electric) produce side effects that accompany stone disintegration in patients. Furthermore, their biological effects are described as injuries to organs or tissues in vivo that have been exposed to the focal area of shock waves and as damage to cells in culture that have been treated with shock waves. * Dedicated to Prof. Dr. Wolfgang Eisenmenger on the occasion of his 60th birthday Side effectsIn kidney-or gallstone treatment with shock waves, side effects are equivocally classified and certainly depend not only on the number and energy of the applied shock waves but also on the disposition of the patients. Petechial bleeding of the skin that can be observed macroscopically has been found in about 10% of patients [29]. Varying degrees of subcapsular fluid collection and hemorrhage have been detected using different methods [4,37,71].Most of the damage typically caused by shock-wave treatments is routinely observed and is not considered to represent severe pathological change, but the occurrence of perirenal hematoma has increased significantly in patients with pre-existing or poorly controllable hypertension [47]. Physiological tests have revealed only minor, transient reductions of renal plasma flow in the treated kidney [45,82] and no clinically relevant changes in blood chemistry [17]. Furthermore, cytoplasmic enzymes have been reported to be only transiently released into the blood and urine of shock-wave-treated patients [46]. Kishimoto et al. [46] ha...

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“…Extracorporeal shock wave lithotripsy is widely used for the treatment of urolithiasis and its multiple sessions in recurrent stone formation may cause chronic renal failure. The various therapies including thiazide (diuretic) and alkali citrates are used to prevent the recurrence of hypercalciuria and hyperoxaluria, which induce calculi formation, but evidence for their efficacy is less [3][4][5]. Therefore, there is a need to establish medical treatment to prevent recurrent stone formation.…”

Section: Introductionmentioning

confidence: 99%

Study of in Vitro Anti-Lithiatic Effect of Ipomoea Batatas (L) Leaves and Tuberous Roots

Sathish

Jeyabalan

2018

Asian J Pharm Clin Res

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Objective: The present study was to demonstrate the in vitro anti-lithiatic effect of Ipomoea batatas (Convolvulaceae) leaves and tuberous roots. Methods:The obtained ethanolic extract of I. batatas leaves and tuberous roots (EIBL and EIBR) and aqueous extract of I. batatas leaves and roots (AIBL and AIBR) were used for this in vitro study. The dissolution method of calcium oxalate by titrimetry method and calcium phosphate by colorimetric method was studied. Nucleation and aggregation of calcium oxalate crystals were determined by a spectrophotometric assay. Results:In the estimation of calcium oxalate by titrimetry method, the I. batatas leaves and roots have very significant (p<0.01) capability to dissolve calcium oxalate. Percentage dissolution of calcium oxalate crystals was found to be 37.53%, 22.74%, 39.74%, and 24.28% for EIBL, AIBL, EIBR, and AIBR, respectively. In the estimation of calcium phosphate by colorimetric method, the percentage dissolution of calcium phosphate crystals by EIBL, AIBL, EIBR, and AIBR was found to be 67.15%, 43.17%, 76.74%, and 47.96%, respectively. The I. batatas leaves and roots were significantly (p<0.01) dissolved calcium phosphate also. The results were clearly shown that I. batatas extracts significantly (p<0.01) inhibited both nucleation and aggregation of calcium oxalate crystals by concentration-dependent manner. The maximum percent inhibition of calcium oxalate nucleation by EIBL, AIBL, EIBR, and AIBR was found to be 59.09%, 50.0%, 84.09%, and 47.73%, respectively, at 1000 µg/ml. The EIBL, AIBL, EIBR, and AIBR were inhibited calcium oxalate aggregation by 63.46%, 36.54%, 84.61%, and 42.3%, respectively, at 1000 µg/ml. Conclusions:The results clearly indicate that I. batatas leaves and tuberous roots were found to express in vitro anti-lithiatic potential.

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Side Effects of Extracorporeal Shock-Wave Exposure in Patients Treated by Extracorporeal Shock-Wave Lithotripsy for Upper Urinary Tract Stone

Cited by 103 publications

References 0 publications

Examination of Aggravating Factors of Urinary Excretion of N-Acetyl-Beta-<i>D</i>-Glucosaminidase after Extracorporeal Shock Wave Lithotripsy

Examination of Aggravating Factors of Urinary Excretion of N-Acetyl-Beta-<i>D</i>-Glucosaminidase after Extracorporeal Shock Wave Lithotripsy

Biological effects of shock waves

Study of in Vitro Anti-Lithiatic Effect of Ipomoea Batatas (L) Leaves and Tuberous Roots

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