Blood pressure changes following extracorporeal shock wave lithotripsy and other forms of treatment for nephrolithiasis

Article Abstract:

In 1980, a new mode of treatment for nephrolithiasis (kidney stones) was introduced. Extracorporeal shock wave lithotripsy (ESWL) uses shock waves to break up the stones without surgery or other invasive procedures. The technique was heralded as unusually safe, and quickly gained acceptance. But after several years of experience with ESWL, it became clear that this technique did have some adverse effects. Kidney tissue is injured by the shock waves, and bleeding inevitably results. Studies using imaging techniques such as computed tomographic scanning have shown that the tissue in and around the kidney is damaged by most ESWL treatments. In 1986, physicians first reported elevations in blood pressure occurring immediately after ESWL, and some patients followed over time developed high blood pressure (hypertension). The risk of hypertension following ESWL and other treatments for stones in the urinary tract was assessed in 961 patients. Detailed studies of blood pressure were undertaken at least one year after treatment. A comparison was made between the 731 patients who had ESWL as the only treatment and 171 controls who either passed the stone spontaneously or had ureteroscopy, examination of the tube that connects each kidney to the bladder. The annual increase in the incidence of hypertension did not differ between the two groups, and various measures of the intensity of the shock wave treatments were not correlated with hypertension in the ESWL group. But a significant increase in diastolic blood pressure, relaxation phase of the heart muscle which alternates with the contraction phase, (0.78 mm Hg) did occur after ESWL treatment, while it dropped slightly in the control group. The clinical importance of this change in diastolic pressure is not clear and should be studied further. (Consumer Summary produced by Reliance Medical Information, Inc.)

Kidney stones, Ultrasonic lithotripsy, Calculi, Urinary, Urinary stones

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The role of the kidney in hypertension

Article Abstract:

Both animal and human studies provide strong evidence that all forms of hypertension are the result of kidney dysfunction. The kidney controls blood pressure by excreting sodium and water whenever blood pressure and volume rise. Anything that impairs the ability of the kidney to excrete sodium and water under these conditions will cause hypertension. All of the animal models of hypertension were developed by using some surgical procedure or drug that impaired sodium and water excretion by the kidney. Human and animal studies show that during chronic hypertension, the kidney excretes sodium and water at higher pressures. Most antihypertensive drugs shift excretion down to lower pressures. Research on kidney transplants reveals that a kidney donated by someone with hypertension will cause hypertension in the recipient. And a kidney from someone with normal blood pressure will eliminate hypertension in the recipient.

Physiological aspects, Kidneys, Kidney

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Extracorporeal shock wave therapy for the treatment of chronic calcifying tendonitis of the rotator cuff: a randomized controlled trial

Article Abstract:

Extracorporeal shock wave therapy (ESWT) may be effective for treating calcifying tendonitis in the shoulder, according to a study of 144 patients. Tendonitis is an inflammation of a tendon, which is a band of connective tissue that attaches muscles to bones. ESWT is similar to a technique called lithotripsy, which is used to treat kidney stones.

Injuries, Rotator cuff (Anatomy), Rotator cuff, Tendinitis

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