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Extracorporeal shockwave lithotripsy for kidney stones reduces blood pressure: use of 24-hour ambulatory monitoring for study of blood-pressure changes induced by SWL.

Research paper by V V Protogerou, Ch Ch Deliveliotis, A A Protogerou, V V Kotsis, V V Karayiannis, N N Zakopoulos, A A Kostakopoulos

Indexed on: 10 Mar '04Published on: 10 Mar '04Published in: Journal of endourology / Endourological Society



Abstract

To investigate the effects of shockwave lithotripsy (SWL) on blood pressure with the use of 24-hour ambulatory blood-pressure monitoring (ABPM).We studied three groups of patients. Group I consisted of 60 patients with kidney stones treated with SWL. Group II was formed by 30 patients with stones in the lower third of the ureter treated in situ with SWL, and group III consisted of 30 patients with ureteral stones treated with ureteroscopy (URS). The ABPM measurements were performed before stone treatment, immediately after, and then every 3 months through 1 year.There was no new onset of hypertension in any group. The prevalences of hypertension before stone treatment were 21 (35%), 12 (40%), and 9 (30%) for groups I, II, and III, respectively. One-year post treatment, the numbers of hypertensive patients found for groups I, II, and III were 15 (25%), 11 (33.3%), and 8 (22.2%), respectively. In group I, a statistically significant decrease in blood pressure values was noted 1 year post-treatment (p<0.05). This decrease was related (p<0.05) to the power (r=0.35), as well as to the product of the number and the power (r=0.25), of the shockwaves applied.Extracorporeal lithotripsy for kidney stone may be responsible for a drop in blood pressure possibly caused by alteration in intrarenal metabolism.