Thursday, May 27, 2010

TOPIC DISCUSSION: Shock wave lithotripsy for kidney stones

Shock wave lithotripsy has been used for many years now for treatment of kidney stones. This might be old news to some people but i learned about this recently that around 2006-2007, there was a big debate about SWL causing DM and HTN.  Results from a retrospective study of 630 patients by researchers at the Mayo Clinic showed a more-than-threefold increased risk of diabetes and a 1.5-fold increased risk of hypertension among patients who underwent SWL 19 years previously compared with a cohort of matched, conservatively treated, nephrolithiasis patients. This was published in the Journal of Urology.
Another study showed the opposite in 2008.
The mechanism of this is unclear, but one possibly is direct toxicity from damage of islet cells from the shock.

The HTN is likely from the scarring and intrinsic kidney damage. 
This is still controversial and under debate in the medical community.

Some good references:

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