Ahmed Zuhal Y, Abdelrahim Ahmed, Gareeballah Awadia, Gameraddin Moawia, Elzaki Maisa, Ali Shima I, Hassan Mohammed A, Mohammed Marwa H, Abouraida Raga A
Department of Diagnostic Radiologic Technology, Faculty of Radiology Science and Medical Imaging, Alzaiem Alazhari University, Khartoum, SDN.
Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarah, SAU.
Cureus. 2024 Sep 19;16(9):e69760. doi: 10.7759/cureus.69760. eCollection 2024 Sep.
Background The effect of extracorporeal shock wave lithotripsy (ESWL) on kidney morphology was evaluated sonographically in patients with renal stones. This study aimed to investigate the effects of ESWL on the kidneys after consecutive sessions. Methods This case-control study included adult participants from December 2018 to August 2022 in three major centers of ESWL treatment. Data were collected from 392 patients (336 treated with ESWL and 56 in the control group). Data were analyzed using SPSS Statistics (IBM Corp., Armonk, USA). Both binary logistic regression and generalized linear regression were applied to determine the factors that predicted the effect of ESWL on kidney length (KL) and cortico-medullary differentiation (CMD). Results The overall effect of ESWL treatment on patients with renal stones was observed in 19.9% disturbed CMD, and 11.6% decreased parenchymal thickness. KL was significantly decreased in patients exposed to ESWL compared to controls (9.103 vs.10.291 cm, p-value < .001). KL decreased significantly as the number of ESWL sessions increased (r = -.209, p-value < .001). After adjustment, the frequencies of ESWL and hydronephrosis were significantly associated with CMD distortion. Patients who were exposed to more than one ESWL session had 2.64 increased odds of distorted CMD as compared to controls (AOR=2.64, 95% CI = 1.040-6.683), and those with hydronephrosis had 1.70 increased odds of distorted CMD as compared to controls (AOR=1.70, 95% CI = 1.188-2.434). Conclusion ESWL significantly affected the renal length and CMD in patients with renal stones. The frequency of ESWL sessions significantly decreased KL and disturbed CMD in patients with renal stones. The outcome was not affected by the number of stones.
采用超声检查评估体外冲击波碎石术（ESWL）对肾结石患者肾脏形态的影响。本研究旨在探讨连续进行ESWL治疗后对肾脏的影响。方法：本病例对照研究纳入了2018年12月至2022年8月在三个主要ESWL治疗中心的成年参与者。收集了392例患者的数据（336例接受ESWL治疗，56例为对照组）。使用SPSS Statistics（美国纽约州阿蒙克市IBM公司）进行数据分析。采用二元逻辑回归和广义线性回归来确定预测ESWL对肾长（KL）和皮髓质分化（CMD）影响的因素。结果：观察到ESWL治疗对肾结石患者的总体影响为CMD紊乱占19.9%，实质厚度减少占11.6%。与对照组相比，接受ESWL治疗的患者KL显著降低（9.103 vs.10.291 cm，p值<0.001）。随着ESWL治疗次数的增加，KL显著降低（r = -0.209，p值<0.001）。调整后，ESWL频率和肾积水与CMD扭曲显著相关。与对照组相比，接受一次以上ESWL治疗的患者CMD扭曲的几率增加2.64倍（比值比[AOR]=2.64，95%置信区间[CI]=1.040 - 6.683），肾积水患者CMD扭曲的几率比对照组增加1.70倍（AOR=1.70，95% CI = 1.188 - 2.434）。结论：ESWL对肾结石患者的肾长和CMD有显著影响。ESWL治疗次数显著降低了肾结石患者的KL并扰乱了CMD。结果不受结石数量的影响。
