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Relationship between Kidney Size, Renal Injury, and Renal Impairment Induced by Shock Wave Lithotripsy

LYNN R. WILLIS^*, ANDREW P. EVAN, BRET A. CONNORS, PHIL BLOMGREN, NAOMI S. FINEBERG and JAMES E. LINGEMAN^§

^* Department of Pharmacology and Toxicology, School of Medicine, Indiana University, Indianapolis, Indiana.
Department of Anatomy, School of Medicine, Indiana University, Indianapolis, Indiana.
Department of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana.
^§ Department of Urology, Methodist Hospital of Indiana, Inc., Indianapolis, Indiana.

Correspondence to Dr. Lynn R. Willis, Department of Pharmacology and Toxicology, Indiana University School of Medicine, 635 Barnhill Drive, Indianapolis, IN 46202. Phone: 317-274-1562; Fax: 317-274-1560; E-mail: willisl{at}iupui.edu

Abstract

Abstract. The relationship between kidney size and impaired renal function induced by shock-wave lithotripsy (SWL) was examined in 6- and 10-wk-old anesthetized pigs. Each pig received 2000 shock waves, 24 kV, or sham SWL to the lower pole calyx of one kidney. Bilateral GFR, renal plasma flow (RPF), and para-aminohippurate extraction was measured 1 h before and 1 and 4 h after SWL. The kidneys were then removed for morphometric analysis. Mean kidney weights were 66.1 ± 2.7 g (n = 9) and 103.1 ± 3.3 g (n = 8) in the SWL groups, and 60.1 ± 2.6 g (n = 9) and 82.3 ± 4.0 g (n = 9) in the sham-SWL groups. SWL-induced lesions occupied a significantly greater volume of the small kidneys (6.1 ± 1.7 vol % versus 1.5 ± 0.2 vol % in the large kidneys). RPF was significantly reduced by SWL in small and large kidneys, but to a significantly greater extent in small kidneys. RPF was also significantly reduced in the contralateral kidneys of both groups, but only at 1 h after SWL. SWL significantly reduced GFR to similar degrees in both kidneys of both groups, regardless of kidney size. Para-aminohippurate extraction was likewise reduced to similar degrees in both groups, but this effect was evident only in the SWL-treated kidneys, and only in the pole to which the shock waves had been applied. The injury induced by SWL affected a larger fraction of small kidneys than large ones, and the renal vasoconstriction induced by SWL was greatest in small kidneys.

This article has been cited by other articles:

				L. R. Willis, A. P. Evan, B. A. Connors, R. K. Handa, P. M. Blomgren, and J. E. Lingeman Prevention of Lithotripsy-Induced Renal Injury by Pretreating Kidneys with Low-Energy Shock Waves J. Am. Soc. Nephrol., March 1, 2006; 17(3): 663 - 673. [Abstract] [Full Text] [PDF]

				B. A. CONNORS, A. P. EVAN, L. R. WILLIS, P. M. BLOMGREN, J. E. LINGEMAN, and N. S. FINEBERG The Effect of Discharge Voltage on Renal Injury and Impairment Caused by Lithotripsy in the Pig J. Am. Soc. Nephrol., February 1, 2000; 11(2): 310 - 318. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673