Gilbert B R, Riehle R A, Vaughan E D
Department of Surgery (Division of Urology), New York Hospital/Cornell University Medical Center, New York.
J Urol. 1988 Mar;139(3):482-5. doi: 10.1016/s0022-5347(17)42498-0.
Extracorporeal shock wave lithotripsy has become a major treatment modality for symptomatic upper tract renal stone disease. Although proved to be effective in disintegrating stones the short-term and long-term effects on renal function are not yet known. We evaluated several basic physiological parameters, namely creatinine clearance, fractional sodium excretion, protein excretion and urine osmolality before and after extracorporeal shock wave lithotripsy in 26 consecutive patients in an attempt to quantitate changes in renal function. In addition, a 3 to 6-month followup study of patients showing excessive protein excretion with extracorporeal shock wave lithotripsy also is reported. Our data suggest that with extracorporeal shock wave lithotripsy transient nephrotic range proteinuria occurs immediately after treatment, returning to normal values within 3 to 6 months after treatment without a change in the glomerular filtration rate. The glomerular filtration rate increases after successful extracorporeal shock wave lithotripsy in patients with kidneys obstructed by the treated stone before the start of the procedure, and the kidney appears to maintain its ability to dilute urine and to conserve sodium after treatment.
体外冲击波碎石术已成为有症状的上尿路肾结石疾病的主要治疗方式。尽管已证明其在结石分解方面有效，但对肾功能的短期和长期影响尚不清楚。我们评估了26例连续患者在体外冲击波碎石术前和术后的几个基本生理参数，即肌酐清除率、钠排泄分数、蛋白质排泄和尿渗透压，试图量化肾功能的变化。此外，还报告了对体外冲击波碎石术后出现蛋白质排泄过多的患者进行的3至6个月的随访研究。我们的数据表明，体外冲击波碎石术后会立即出现短暂的肾病范围蛋白尿，在治疗后3至6个月内恢复到正常值，而肾小球滤过率没有变化。在治疗前因结石梗阻肾脏的患者中，成功进行体外冲击波碎石术后肾小球滤过率会增加，并且治疗后肾脏似乎保持其稀释尿液和保留钠的能力。
