Pirola Giacomo Maria, Micali Salvatore, Sighinolfi Maria Chiara, Martorana Eugenio, Territo Angelo, Puliatti Stefano, Bianchi Giampaolo
Department of Urology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy.
Urolithiasis. 2016 Oct;44(5):465-70. doi: 10.1007/s00240-016-0867-8. Epub 2016 Mar 11.
To assess the incidence of long-term side effects after shock-wave lithotripsy treatment performed with an electromagnetic Dornier Lithotripter S device. A specific follow-up was undertaken on a cohort of 100 selected patients that underwent SWL for a single renal stone in our center from 2002 to 2004. Previous and current data were compared using the Student t test. Factors associated with the incidence of hypertension and diabetes mellitus were determined. Ten years after treatment, mean serum creatinine level and glomerular filtration rate remained similar to previous values (serum creatinine level: 0.96 ± 0.22 vs. 0.92 ± 0.19 mg/dL; glomerular filtration rate: 92.8 ± 17.8 vs. 88.1 ± 21.7 mL/min). There were marked increases in blood cholesterol, blood pressure, and blood glucose levels, while smoking decreased. Age, glomerular filtration rate, body mass index, blood glucose and blood pressure at the time of treatment were significantly associated with the presence of hypertension and diabetes mellitus at follow-up; blood cholesterol was associated with diabetes mellitus development. After 10 years, overall renal function appeared to have been unaffected by shock-wave lithotripsy treatment. The increased rate of hypertension and diabetes mellitus were consistent with the incidence in the global population. This is the first report on the long-term safety of a third generation electromagnetic lithotripter, and indicates that there are no long-term sequelae.
评估使用电磁式多尼尔碎石机S设备进行冲击波碎石治疗后长期副作用的发生率。对2002年至2004年在我们中心接受单发性肾结石冲击波碎石治疗的100例选定患者进行了特定随访。使用学生t检验比较既往和当前数据。确定与高血压和糖尿病发生率相关的因素。治疗十年后,平均血清肌酐水平和肾小球滤过率与之前的值相似(血清肌酐水平:0.96±0.22 vs. 0.92±0.19mg/dL;肾小球滤过率:92.8±17.8 vs. 88.1±21.7mL/min)。血胆固醇、血压和血糖水平显著升高,而吸烟率下降。治疗时的年龄、肾小球滤过率、体重指数、血糖和血压与随访时高血压和糖尿病的存在显著相关;血胆固醇与糖尿病的发生相关。十年后,总体肾功能似乎未受冲击波碎石治疗的影响。高血压和糖尿病的发生率增加与全球人群的发生率一致。这是关于第三代电磁碎石机长期安全性的首次报告,表明不存在长期后遗症。