To evaluate the association of shock-wave lithotripsy (SWL) for kidney stones and hypertension or diabetes.
Patients with urolithiasis treated by SWL were retrospectively identified. To assess whether shock-wave application to the kidney is associated with long-term adverse effects, patients after SWL for kidney stones were selected as the main group of interest. Patients treated with shock waves for distal ureter stones only were chosen as a comparison group. A questionnaire was sent to all patients to assess the prevalence of hypertension and diabetes. The Swiss Health Survey (SHS) dataset was used as an additional comparison group.
After a median follow-up of 13.7 years, the odds ratio (OR) to report hypertension [OR 1.30 (95% CI 1.10-1.95)] or diabetes [OR 1.54 (95% CI 1.21-1.97)] was significantly higher in patients treated with SWL compared to the SHS dataset. In comparison with the kidney group, participants in the SHS had a significantly lower OR to report hypertension at follow-up [OR 0.79 (95% CI 0.65-0.95)], while the OR to report hypertension [1.16 (95% CI 0.79-1.70)] was not significantly different in the distal ureter group. For diabetes, a significantly lower [OR 0.60 (95% CI 0.46-0.78)] in the SHS group and a non-significantly lower [OR 0.68 (95% CI 0.38-1.22)] in the ureter group was noted compared to the kidney group.
Compared to the SHS data set SWL was in general associated with hypertension and diabetes. However, no clear difference between patients after SWL to the kidney compared to SWL to the distal ureter was seen and thus the data do not support a causal relationship.
International urology and nephrology. 2018 May 21 [Epub ahead of print]
Christian Daniel Fankhauser, Nilufar Mohebbi, Josias Grogg, Alexander Holenstein, Qing Zhong, Thomas Hermanns, Tullio Sulser, Johann Steurer, Poyet Cedric
Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. ., Division of Nephrology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Department of Pathology of Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Horten Centre for Patient Oriented Research and Knowledge Transfer, University Hospital Zurich, University of Zurich, Zurich, Switzerland.