Certain patient characteristics, such as hypertension and use of medications with anti-platelet effects, have been identified as risk factors for this SWL complication.
Researchers from Tokyo, Japan reviewed an enormous (26,969 patient in 482 hospitals) national database to compare the effect of the type of shock wave generators on the incidence of renal hemorrhage. The overall incidence of SWL related renal hemorrhage was 0.50% in patients treated for kidney stones and 0.14% in patients with ureteral stones. Using multivariate logistic regression analysis they found that a high annual SWL session volume and a piezoelectric type of shock wave generator were significant predictors of renal hemorrhage. It stands to reasons that the higher the volume of cases done at a center the more likely they are to have this complication given the low overall incidence. However, it is interesting that the piezoelectric lithotripter was associated with this complication and is likely related to the pressure of the acoustic shock wave generated by this technology.
Presented by Toru Sugihara, et al. at the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Elspeth M. McDougall, MD, FRCSC, Professor of Urology/Director, Surgical Education Institute at the University of California, Irvine.
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