Renal Injury by Extracorporeal Shock Wave Lithotripsy

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Abstract
Numerous clinical and experimental reports indicate that shock wave lithotripsy (SWL) causes acute renal effects in a majority, if not all, treated kidneys. The induced acute renal damage may be severe, and clinical findings point to several risk factors that appear to predispose SWL patients to an increased incidence of renal trauma. In addition, compelling clinical data suggest that exposure to shock waves in therapeutic doses is associated with at least three chronic adverse effects: (1) an accelerated rise in arterial blood pressure; (2) a decrease in renal function; and (3) an increased rate of stone recurrence. These long-term complications raise concern about the potential for increased and significant patient morbidity as SWL continues to gain in popularity. Such concern is heightened by the prospect that little is known about the factors of SWL treatment that contribute to stone comminution or cause tissue injury.