BERKELEY, CA (UroToday.com) - This study addresses whether or not diabetes and hypertension are long-term complications of extracorporeal shockwave lithotripsy (SWL) for urolithiasis.
It had been reported that patients who had received SWL therapy were at an increased risk of developing diabetes mellitus and hypertension following treatment. Our aim was to determine if such an association existed for stone patients treated at our centre, and if so, whether lithotriptor parameters influenced one's complication risk. To this end, we performed a retrospective chart review of 727 patients from 1985 to 1989. From 1985-1987 patients were treated with an original Dornier HM-3 lithotriptor while patients from 1988-1989 were treated with a modified HM-3 (dual shockwave). Disease prevalence was compared to the general population using univariate statistics. Multivariate statistics were used to determine if patient parameters such as type of lithotriptor, body mass index, age, or sex affected disease risk.
Patients in our dataset with kidney stones were more likely to be overweight and obese relative to the general population. As well, the prevalence of diabetes and hypertension was increased in the patients undergoing lithotripsy. The univariate data is consistent with the notion that body mass affects one's risk of forming a stone; however, on multivariate analysis, there was no association between lithotriptor modality as a risk factor for either sequelae. As such, our data found no association that SWL was an etiologic factor for our patients.
It is probable that patients who formed stones two decades prior had an elevated risk of developing metabolic dysfunction later in life, including diabetes and hypertension. It is possible that stone formation may be a marker of escalating metabolic disturbance in some patients. This is an important point, particularly for overweight or obese patients who have stone disease on first presentation but have not yet developed frank diabetes or hypertension. Regardless, these findings suggest that diabetes and hypertension are not true complications of SWL. Urologists developing treatment plans for treatment of a kidney stone can safely continue to consider SWL as first line therapy. Given the efficacy, widespread use, and minimally invasive nature of SWL this is welcome news for patients.
Ben H. Chew, MSc, MD, FRCSC as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.