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Fadallah M. et al., 2023: The Ideal Interval Between Repeated Shockwaves Lithotripsy Sessions for Renal Stones: A Randomized Controlled Trial.

Fadallah M, Abdelhalim A, Hashem A, Mortada WI, Ibrahim HAM, Sheir KZ, Harraz AM, El-Kenawy MR, El-Nahas AR
Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Department of Urology, West Virginia University, Morgantown, West Virginia, USA.
Laboratory Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Abstract

Objectives: To assess the ideal interval between repeated extracorporeal shockwave lithotripsy (SWL) for renal stones. Patient and Methods: Eligible patients with a single renal stone ≤20 mm who required SWL were randomly assigned to one of three groups based on intervals between first and second sessions. Patients underwent the second session after 3, 7, and 14 days in Groups 1, 2, and 3, respectively. Tubular functions were assessed through comparisons of urinary execration of kidney injury molecule-1 (KIM-1), neutrophil gelatinase associated lipocalin (NGAL), and interleukin-18 (IL-18) with pre-SWL values, whereas glomerular function was assessed by comparisons of protein/creatinine ratio with pre-SWL and changes in ipsilateral renal function on isotope scans. Treatment success was assessed by noncontrast CT after 3 months. Results: All demographics of the 166 patients included in the study were comparable between the three groups. There were significant elevations of tubular biomarkers and protein/creatinine ratio after first and second SWL sessions compared with pre-SWL values (p < 0.0001). All tubular biomarkers returned to pre-SWL values at 7 and 14 days after second session, whereas they remained significantly elevated 3 days after second session (p = 0.027, < 0.001 and <0.001 for KIM-1, NGAL, and IL-18, respectively). SWL success was 73.6% in Group 1, 83.7% in Group 2, and 81% in Group 3. A significant decrease in ipsilateral renal split function was observed in Group 1 at the 3-month follow-up. Conclusions: An interval of 7 days is required between SWL sessions when treating renal stones to allow for complete recovery of kidney functions. Clinical Trial Registration: ID: NCT04575480.

.J Endourol. 2023 Dec;37(12):1305-1313. doi: 10.1089/end.2023.0345. PMID: 37767632 Clinical Trial.

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Comments 1

Peter Alken on Wednesday, 15 May 2024 11:00

REVIEWERS CHOICE
Since decades the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt is a center of highest excellence in the clinical and academic handling of all urological diseases. The present paper is the best clinical research paper on ESWL I have read since many years.

Peter Alken

REVIEWERS CHOICE Since decades the Urology and Nephrology Center, Mansoura University, Mansoura, Egypt is a center of highest excellence in the clinical and academic handling of all urological diseases. The present paper is the best clinical research paper on ESWL I have read since many years. Peter Alken
Friday, 12 July 2024