The adverse effect of shock-wave lithotripsy (SWL) for renal stones on blood pressure is currently defined as its post-treatment increase.
On the contrary, we hypothesize that even mild, unilateral renal obstruction initiates an increase in blood pressure. Then, in absence of treatment-induced injury, the stone removal should decrease the blood pressure. We derived the formula to assess the expected change in the mean arterial pressure following relief of renal obstruction without affecting the kidney functions. The predictions were well replicated in the cohort of patients with renal stone treated with parenchyma-saving open surgery, with 6.4mmHg decrease at 3months. On the contrary, in SWL cohort, instead of the expected 4.7mmHg decrease, the blood pressure was unchanged. In conclusion, the absence of decrease in blood pressure is a very common adverse effect of SWL, leading to an epidemiologically significant increase in the risk of arterial vascular events.
Written by:
Eterović D, Situm M, Marković V, Kuna K, Punda A. Are you the author?
Department of Nuclear Medicine, University Hospital Split and Department of Medical Physics, University of Split School of Medicine, Croatia; Department of Urology, University Hospital Split and University of Split School of Medicine, Croatia; Department of Nuclear Medicine, University Hospital Split and University of Split School of Medicine, Croatia; Department of Gynecology and Obstetrics, University Hospital Sisters of Charity, Zagreb, Croatia.
Reference: Med Hypotheses. 2014 Jun;82(6):691-3.
doi: 10.1016/j.mehy.2014.03.005
PubMed Abstract
PMID: 24674349
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