Fayad A et al, 2012: Effect of extracorporeal shock wave lithotripsy on kidney growth in children
Fayad A, El-Sheikh MG, El-Fayoumy H, El-Sergany R, Abd El Bary A.
Urology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Abstract
PURPOSE: We investigated whether shock wave lithotripsy affects kidney growth in children.
MATERIAL AND METHODS: This prospective controlled study included 150 children with renal stones who presented for shock wave lithotripsy between March 2005 and February 2010 (group A). The control arm included 100 children without any urological problems who were enrolled in the study after obtaining written maternal consent (group B). All children in both groups underwent abdominal ultrasound to assess renal size (bipolar renal length), which was repeated after 6 months for group A and after 1 year for both groups.
RESULTS: Bipolar renal size in group A increased significantly at 6 months and 1 year after shock wave lithotripsy. Renal growth did not differ based on patient age at shock wave lithotripsy (p _ 0.472), number of shock wave lithotripsy sessions (p _ 0.65) or number of stones (p _ 0.405). There was no significant difference between the rate of kidney growth in children who underwent shock wave lithotripsy during the year of the study and normal controls.
CONCLUSIONS: Shock wave lithotripsy has no deleterious effect on the normal rate of renal growth in children. This outcome is not affected by either the number of stones or the age of the child at shock wave lithotripsy
J Urol. 2012 Sep;188(3):928-31. doi: 10.1016/j.juro.2012.04.120. Epub 2012 Jul 20.
PMID: 22819405 [PubMed - indexed for MEDLINE]
Comments 1
The clinically interesting conclusion from this report is that SWL of stones in child kidneys did not negatively affect the growth rate of the kidneys. This was obvious during a follow-up period of one year. The result should be considered in view of 2 or 3 repeated sessions in 35 % of the children. Moreover, the stone-free rate was 92 %. Apparently the young renal tissue is less vulnerable than expected and at lower risk of damage than is the case in adults. The well recognized efficient elimination of stone fragments needs to be emphasised. The lesson learnt is that SWL seems to be an excellent method for stone removal in children.
Hans-Göran Tiselius