Evaluation of effects of Extracorporeal Shock Wave Lithotripsy on renal vasculature with Doppler ultrasonography.

OBJECTIVES In this prospective study, we aimed to demonstrate the effects of Extracorporeal Shock Wave Lithotripsy (ESWL) on renal blood flow in patients treated for renal/ ureteral stones. MATERIAL AND METHODS The study group comprised 41 patients (26 males, 15 females, aged between 18-63 years, mean age 45 years), 23 with renal and 18 with ureteral stones, who underwent ESWL between March 2010 and January 2011. Colour Doppler ultrasonography and pulsed wave spectral analysis was performed before, 1 hour, and 7 days after ESWL to both ipsilateral and contralateral kidneys in order to measure resistive index (RI), pulsatility index (PI) and acceleration time (AT) values. RESULTS One hour after ESWL, RI and PI values showed significant increase from pre-ESWL values in both ipsilateral and contralateral kidneys. However, no significant change was found in AT values. Seven days after ESWL, PI in both ipsilateral and contralateral kidneys and RI in contralateral kidney returned to pre-ESWL values. But, 7 days after ESWL, RI in the ipsilateral kidney did not return to pre-ESWL values, although decrease in RI values were observed. CONCLUSİON: Spectral Doppler analysis can provide valuable information as a non-invasive method to assess the hemodynamic changes and renal microcirculation status in cases managed with ESWL.

[1]  H. Tokgöz,et al.  Changes in renal resistive index after urologic interventions: were untreated kidneys really affected? , 2013, European journal of radiology.

[2]  N. Voyvoda,et al.  Changes in Renal Doppler Ultrasonographic Parameters in Patients Managed with Rigid Ureteroscopy , 2013, Acta radiologica.

[3]  C. Kremser,et al.  Changes of renal blood flow after ESWL: assessment by ASL MR imaging, contrast enhanced MR imaging, and renal resistive index. , 2010, European journal of radiology.

[4]  M. Hiroš,et al.  Effects of extracorporeal shockwave lithotripsy on renal vasculature and renal resistive index (RI). , 2009, Medicinski arhiv.

[5]  D. Briscoe,et al.  Duplex Doppler examination of renal allografts in children: correlation between renal blood flow and clinical findings , 2005, Pediatric Radiology.

[6]  G. Mancini,et al.  Renal changes from extracorporeal shock-wave lithotripsy: evaluation using Doppler sonography , 1994, European Radiology.

[7]  A. Bilici,et al.  Effects of extracorporeal shock‐wave lithotripsy on intrarenal resistive index , 2003, Scandinavian journal of urology and nephrology.

[8]  R. Aliaga,et al.  Utility of intrarenal Doppler ultrasound in the diagnosis of renal artery stenosis. , 2001, European journal of radiology.

[9]  Y. Arai,et al.  Changes in resistive index following extracorporeal shock wave lithotripsy , 1999, International journal of urology : official journal of the Japanese Urological Association.

[10]  B. Brkljačić,et al.  Renal vascular resistance in autosomal dominant polycystic kidney disease , 1997, Acta radiologica.

[11]  G. Bartsch,et al.  New onset hypertension after extracorporeal shock wave lithotripsy: age related incidence and prediction by intrarenal resistive index. , 1997, The Journal of urology.

[12]  A. Evan,et al.  Effects of extracorporeal shock wave lithotripsy to one kidney on bilateral glomerular filtration rate and PAH clearance in minipigs. , 1996, The Journal of urology.

[13]  M. Topsakal,et al.  Renal hemodynamics in patients with obstructive uropathy evaluated by color Doppler sonography. , 1996, European urology.

[14]  J. Rubin,et al.  Detection of renal artery stenosis with Doppler sonography: it is more complicated than originally thought. , 1995, Radiology.

[15]  G. Bartsch,et al.  Age-related changes in resistive index following extracorporeal shock wave lithotripsy. , 1995, The Journal of urology.

[16]  A. Shokeir Partial ureteral obstruction: a new variable and reversible canine experimental model. , 1995, Urology.

[17]  K. Sarıca,et al.  Evaluation of renal morphology and vascular function by color flow Doppler sonography immediately after extracorporeal shock wave lithotripsy. , 1993, Journal of endourology.

[18]  K. Derfler,et al.  Duplex Doppler sonography in renal parenchymal disease. Histopathologic correlation. , 1991, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[19]  J M Rubin,et al.  Duplex Doppler US of the kidney: differentiation of obstructive from nonobstructive dilatation. , 1989, Radiology.

[20]  R. Lo,et al.  Renal blood flow pattern by noninvasive Doppler ultrasound in normal children and acute renal failure patients. , 1989, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[21]  J. Lingeman,et al.  Extracorporeal shock wave lithotripsy-induced perirenal hematomas. , 1987, The Journal of urology.

[22]  M. Bernardino,et al.  Kidney changes after extracorporeal shock wave lithotripsy: appearance on MR imaging. , 1987, Radiology.

[23]  P. Arger,et al.  Kidney changes after extracorporeal shock wave lithotripsy: CT evaluation. , 1987, Radiology.

[24]  C. M. Williams,et al.  Renal morphology and function immediately after extracorporeal shock-wave lithotripsy. , 1985, AJR. American journal of roentgenology.

[25]  S. Takahara,et al.  Predictability of renal allograft prognosis during rejection crisis by ultrasonic Doppler flow technique. , 1982, Urology.