Lipid Peroxidation Induced by Shockwave Lithotripsy

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Abstract
To determine the relation between high-energy shockwaves (HESW) and the presence of lipid peroxidation products, juvenile pigs were subjected to shockwave lithotripsy (SWL). After lithotripsy, both treated and control kidneys were analyzed, along with urine samples collected before, during, and after SWL. Thiobarbituric acid-reactive substance (TBARS) and lipid-conjugated diene (CD) concentrations, used as markers for membrane lipid peroxidation, were determined in the kidney and urine samples. Significantly increased mean TBARS concentrations (146%) were associated with homogenates of lithotripsy-treated kidneys, 77.8 ± 20.4 (SD) mmol/g v the controls, 31.4 ± 14.9 mmol/g. Lithotripsy induction of lipid peroxidation products in the cortex, the gross damage site, and the respective medulla were also examined. In HESW-treated cortex samples, increased TBARS concentrations were seen—75.0 ± 21.3 mmol/g—compared with untreated controls— 45.2 ± 5.6 mmol/g—while increased CD concentrations (168%) were observed in the medulla of HESW-treated samples. No significant differences were observed in TBARS or CD concentrations in urine samples from control or treated kidneys, yet specific lipid hydroperperoxides were detected in the urine of HESW-treated kidneys. We conclude that HESW lithotripsy of swine kidneys is associated with increased lipid peroxidation products that may cause further cellular damage. Lipid peroxidation induced by SWL may be one of several mechanisms that lead to other potential bioeffects. Finally, analysis of specific lipid hydroperoxides in the urine of HESW-treated kidneys may serve as a noninvasive marker of renal injury after clinical SWL.