Department of Urology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Research and Training Hospital, Istanbul, Turkey.
Department of Urology, Medical School, Biruni University, Istanbul, Turkey.
Urolithiasis. 2024 Oct 9;52(1):136. doi: 10.1007/s00240-024-01639-3.
Extracorporeal Shock Wave Lithotripsy (ESWL) is a commonly used method for the noninvasive treatment of kidney stones. However, achieving optimal treatment outcomes and minimizing potential damage to the kidney necessitates careful consideration for the total amount of energy utilized. This study aims to investigate whether urine pH and urine specific gravity have an impact on the total amount of energy applied during SWL.
Between January 2023 and December 2023, 129 patients with renal stones underwent SWL in our department using the Storz Medical Modulith Inline lithotripter. Stone-free rates, complications, and the impact of patient, urine, and stone characteristics on energy use were analyzed. Urine samples were analyzed for pH and specific gravity. Stone characteristics, including size, HU, and skin-to-stone distance, were recorded. The obtained data were evaluated regarding the possible relationship between the total energy amount (determined as a risk factor) and the age, BMI, urine pH, urine specific gravity, stone size, HU, and skin-to-stone distance by using the Pearson correlation coefficient. p-value of < 0.05 was considered statistically significant.
Evaluation of our findings revealed a negative linear relationship between total amount of energy used and the urine pH, indicating a decrease in the total energy amount as urine pH shifts towards alkaline values (p = 0.038; p < 0.05). However, no statistically significant relationship was observed between age, BMI, urine specific gravity, stone size, HU, and skin-to-stone distance and the total energy amount.
Our findings demonstrated a significant relationship between urine pH and the total amount of energy applied during SWL sessions, suggesting the need for further prospective research to better understand the possible association between these two parameters. Such investigations could contribute to the development of more reasonable and effective strategies for kidney stone treatment in an attempt to minimize the potential kidney damage.
体外冲击波碎石术（ESWL）是一种常用于治疗肾结石的非侵入性方法。然而，为了实现最佳的治疗效果并最小化对肾脏的潜在损伤，需要仔细考虑所使用的总能量。本研究旨在探讨尿 pH 值和尿比重是否会影响 ESWL 过程中应用的总能量。
2023 年 1 月至 2023 年 12 月期间，我科采用 Storz Medical Modulith Inline 碎石机对 129 例肾结石患者进行 ESWL。分析结石清除率、并发症以及患者、尿液和结石特征对能量使用的影响。分析尿液样本的 pH 值和比重。记录结石特征，包括大小、HU 值和皮肤到结石的距离。使用 Pearson 相关系数评估获得的数据，评估总能量量（确定为风险因素）与年龄、BMI、尿 pH 值、尿比重、结石大小、HU 值和皮肤到结石的距离之间的可能关系。p 值<0.05 被认为具有统计学意义。
对我们的发现进行评估，发现使用的总能量与尿 pH 值之间存在负线性关系，表明随着尿 pH 值向碱性值变化，总能量量减少（p=0.038；p<0.05）。然而，年龄、BMI、尿比重、结石大小、HU 值和皮肤到结石的距离与总能量之间没有观察到统计学上的显著关系。
我们的研究结果表明，尿 pH 值与 ESWL 治疗过程中应用的总能量之间存在显著关系，这表明需要进一步进行前瞻性研究，以更好地了解这两个参数之间可能的关联。这些研究可以为开发更合理、更有效的肾结石治疗策略提供依据，以尽量减少潜在的肾脏损伤。
