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Krambeck AE et al, 2010: Shock wave lithotripsy is not predictive of hypertension among community stone formers at long-term followup

Krambeck AE, Rule AD, Li X, Bergstralh EJ, Gettman MT, Lieske JC
Department of Urology, Mayo Clinic School of Medicine, Rochester, Minnesota 55905, USA.


Abstract

PURPOSE: Concern exists over the subsequent development of hypertension after shock wave lithotripsy for the treatment of symptomatic urolithiasis. Referral bias and lack of long-term followup have been limitations of prior studies.

MATERIALS AND METHODS: We identified all Olmsted County, Minnesota residents with a diagnosis of urolithiasis from 1985 to 2008. The charts were electronically queried for hypertension and obesity by diagnostic codes, and use of shock wave lithotripsy by surgical codes. All patients first diagnosed with hypertension before or up to 90 days after the first documented kidney stone were considered to have prevalent hypertension and were excluded from analysis. Cox proportional hazards models were used to assess the association of shock wave lithotripsy with a subsequent diagnosis of hypertension.

RESULTS: We identified 6,077 patients with incident urolithiasis with more than 90 days of followup. We excluded 1,295 (21.3%) members of the population for prevalent hypertension leaving 4,782 patients with incident urolithiasis for analysis. During an average followup of 8.7 years new onset hypertension was diagnosed in 983 (20.6%) members of the cohort at a mean of 6.0 years from the index stone date. Only 400 (8.4%) patients in the cohort were treated with shock wave lithotripsy. There was no significant association between shock wave lithotripsy and the development of hypertension in univariate (p = 0.33) and multivariate modeling controlling for age, gender and obesity (HR 1.03; 95% CI 0.84, 1.27; p = 0.77).

CONCLUSIONS: In a large population based cohort of kidney stone formers we failed to identify an association between shock wave lithotripsy and the subsequent long-term risk of hypertension.

Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
J Urol. 2011 Jan;185(1):164-9. doi: 10.1016/j.juro.2010.09.033. Epub 2010 Nov 13
PMID: 21074794 [PubMed - indexed for MEDLINE]
PMCID: PMC 3086040 [Available on 2012/1/1]

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Comments 1

Hans-Göran Tiselius on Wednesday, 03 August 2011 14:47

The authors of this report looked at the development of hypertension in patients with urolithiasis. During an average follow-up period of 8.7 years onset of hypertension was noted in 20.6 percent of the patients. Only 8.4 percent of them had been treated with. ESWL. The conclusion is that no association could be demonstrated between ESWL and development of hypertension and. This is an important observation in view of some previous reporst of the long-term risk of hypertension following ESWL.

Hans-Göran Tiselius

The authors of this report looked at the development of hypertension in patients with urolithiasis. During an average follow-up period of 8.7 years onset of hypertension was noted in 20.6 percent of the patients. Only 8.4 percent of them had been treated with. ESWL. The conclusion is that no association could be demonstrated between ESWL and development of hypertension and. This is an important observation in view of some previous reporst of the long-term risk of hypertension following ESWL. Hans-Göran Tiselius
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