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Chung JM et al, 2017: Impact of repeated extracorporeal shock wave lithotripsy on prepubertal rat kidney.

Chung JM, Park BK, Kim JH, Lee HJ, Lee SD.
Department of Urology, Pusan National University School of Medicine, Yangsan, Korea.
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Korea.

Abstract

This study aimed to investigate the effects of repeated extracorporeal shock wave lithotripsy (ESWL) on the kidneys of prepubertal and adult rats. Thirty rats were used: 15 were prepubertal (3 weeks of age) with an average body weight of 72.3 ± 3.3 g, and 15 were adults with of 265 ± 11.3 g. The prepubertal and adult rats were separately and randomly allocated to three groups, each consisting of five rats. Following anesthetization, the left kidney of each rat in each group received shock waves in one, two, or three sessions separated by 72 h. The rats in each group were killed 72 h after the last ESWL session, and both kidneys were harvested; the right kidney was used as the control. Renal injury was examined with histological analysis, immunohistochemistry, and Western blot to detecting the expression of heat-shock protein-70, tumor necrosis factor-alpha-α, intercellular adhesion molecule-1, and monocyte chemoattractant protein-1 as markers of renal damage. All of these markers were similarly increased with increased ESWL sessions in both age groups. Histological analysis revealed more serious fibrosis and inflammation in the ESWL-treated kidneys in both groups than in the controls, with the damage increasing with increasing numbers of sessions. ESWL on the kidney increased renal damage according to the number of sessions in both age groups of rats, and the effects of ESWL on renal injury were similar in the two groups. However, there were generally no significant differences in the effects of ESWL on molecular indicators of renal injury between prepubertal and adult rats.

Urolithiasis. 2017 Nov 8. doi: 10.1007/s00240-017-1011-0. [Epub ahead of print]

 

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Kommentare 1

Peter Alken am Montag, 02. April 2018 10:14

The basic idea to do this study is described by the authors: “It is well known that renal trauma differs between children and adults; the pediatric kidney is more susceptible to trauma because of the decreased renal protective mechanisms in childhood. Specifically, in contrast with adults, the pediatric kidney is protected by an immature, more pliable thoracic cage, weaker abdominal musculature, and less perirenal fat, and it sits in a lower abdominal position.” And they concluded: “Thus, it was reasonable to think that the incidence of renal injury following repeated ESWL would be higher in pediatric versus adult patients.”
With the protective mechanisms described, I would not expect the prepubertal kidney to be more susceptible to ESWL trauma, which was demonstrated in the study.

The basic idea to do this study is described by the authors: “It is well known that renal trauma differs between children and adults; the pediatric kidney is more susceptible to trauma because of the decreased renal protective mechanisms in childhood. Specifically, in contrast with adults, the pediatric kidney is protected by an immature, more pliable thoracic cage, weaker abdominal musculature, and less perirenal fat, and it sits in a lower abdominal position.” And they concluded: “Thus, it was reasonable to think that the incidence of renal injury following repeated ESWL would be higher in pediatric versus adult patients.” With the protective mechanisms described, I would not expect the prepubertal kidney to be more susceptible to ESWL trauma, which was demonstrated in the study.
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