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Correlation of vasoconstriction and kidney protection during shock wave lithotripsy.
MedLine Citation:
PMID:  18530715     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Kidney injury in lithotripsy can lead to long-term adverse effects, so minimizing injury is beneficial. We have found that injury is significantly reduced when shock wave (SW) administration is halted briefly- 3-minutes-early in treatment. Previous studies have shown that SWs stimulate renal blood vessels to constrict. Therefore, we tested the idea that vasoconstriction mediates SW-induced protection of the kidney. Doppler ultrasound was used to measure resistive index (RI), a ratio of systolic and diastolic velocities, indicating vasoconstriction. RI was determined for single intralobar arteries in targeted porcine kidneys treated by standard versus protection protocols (2,000SW, uninterrupted vs 500SW-3-min pause-2,000SW) using a Dornier-HM3 lithotripter (2Hz, 24kV). Significant differences in RI from baseline within a group and between groups at various time points were determined using mixed-effect models for repeated measures with Holm's step-down method for multiple comparison adjustment. All animals had similar baselines. Sham pigs (no-SWs) showed no significant change in RI. The protection protocol produced a significant rise (p<0.05, n=8) in RI 15 minutes into treatment, while the standard protocol did not yield a significant rise (p<0.05, n=7) until 45 minutes after treatment. Thus, the treatment protocol shown to protect against injury, induces early vasoconstriction. [NIH-DK43881, NSBRI-SMS00402].
Authors:
Michael R Bailey; Marla Paun; Rajash K Handa; Sujuan Gao; Lynn R Willis; Bret A Connors; James A McAteer; Andrew P Evan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of the Acoustical Society of America     Volume:  123     ISSN:  1520-8524     ISO Abbreviation:  J. Acoust. Soc. Am.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-06-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503051     Medline TA:  J Acoust Soc Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3367     Citation Subset:  IM    
Affiliation:
Center for Industrial and Medical Ultrasound, Applied Physics Lab., University of Washington, 1013 NE 40th St., Seattle, WA 98105, USA, bailey@apl.washington.edu.
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