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Fankhauser CD et al, 2015: Long-term Adverse Effects of Extracorporeal Shock-wave Lithotripsy for Nephrolithiasis and Ureterolithiasis: A Systematic Review.

Fankhauser CD, Kranzbühler B, Poyet C, Hermanns T, Sulser T, Steurer J.
Klinik für Urologie, UniversitätsSpital Zürich, Zürich, Switzerland.

Abstract

This study presents a systematic review of the published literature on possible long-term adverse effects after extracorporeal shock wave lithotripsy (ESWL). Although published disagreement exists, this review finds that previous evidence supporting an association between ESWL and long-term adverse effects is weak and that the majority of studies show no evidence for any increase in post-ESWL incidence of arterial hypertension (24 of 30 studies), diabetes mellitus (4 of 6 studies), kidney dysfunction (14 of 14 studies), or infertility (2 of 2 studies). Currently, no strong evidence exists to support the hypothesis that ESWL causes long-term adverse effects.

Urology. 2015 May;85(5):991-1006. doi: 10.1016/j.urology.2014.12.014. Review

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Peter Alken on Wednesday, 21 October 2015 11:03

Unfortunately the conclusion cannot be better than the data available to make the conclusion:

Quality of the Included Studies
“The SIGN quality was rated high in 3 studies (8%), moderate in 9 studies (23%), and poor in 27 studies
(69%).”

Hypertension
“Data were not pooled in a metaanalysis because of heterogeneous definitions of HTN and data acquisition.”

Diabetes Mellitus
“Because of heterogeneous control groups and the use of different methods to obtain the DM status of the patients, study data were not pooled in a meta-analysis.”
“With only 6 relevant studies, none of them an RCT, it is not possible to make a conclusive statement about whether ESWL might cause DM.”

Chronic Kidney Disease
“Because of the heterogeneous methods used to obtain the patients’ kidney function status and varied definitions of kidney function, data were not pooled in a meta-analysis”
“…the current literature is limited and therefore cannot give a final statement about possible association of ESWL with kidney failure”

Fertility
“… no conclusion about the possible influence of ESWL on fertility can be drawn from the identified studies.”

The two important informations the reader can get from this god review is that a lot of paper is wasted and how to critically read publications.

Unfortunately the conclusion cannot be better than the data available to make the conclusion: Quality of the Included Studies “The SIGN quality was rated high in 3 studies (8%), moderate in 9 studies (23%), and poor in 27 studies (69%).” Hypertension “Data were not pooled in a metaanalysis because of heterogeneous definitions of HTN and data acquisition.” Diabetes Mellitus “Because of heterogeneous control groups and the use of different methods to obtain the DM status of the patients, study data were not pooled in a meta-analysis.” “With only 6 relevant studies, none of them an RCT, it is not possible to make a conclusive statement about whether ESWL might cause DM.” Chronic Kidney Disease “Because of the heterogeneous methods used to obtain the patients’ kidney function status and varied definitions of kidney function, data were not pooled in a meta-analysis” “…the current literature is limited and therefore cannot give a final statement about possible association of ESWL with kidney failure” Fertility “… no conclusion about the possible influence of ESWL on fertility can be drawn from the identified studies.” The two important informations the reader can get from this god review is that a lot of paper is wasted and how to critically read publications.
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