Vestersager SV. et al., 2025: Low-intensity extracorporeal shockwave therapy in patients with diabetic kidney disease: a matched cohort study.
Sofus Valentin Vestersager 1, Sune Moeller Skov-Jeppesen 2, Knud Bonnet Yderstraede 3 4, Claus Bistrup 4 5, Boye L Jensen 6, Lars Lund 7 8 9
1Department of Urology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
2Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.
3Steno Diabetes Center, Odense University Hospital, Odense, Denmark.
4Clinical Institute, University of Southern Denmark, Odense, Denmark.
5Department of Nephrology, Odense University Hospital, Odense, Denmark.
6Department of Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
7Department of Urology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
8Steno Diabetes Center, Odense University Hospital, Odense, Denmark.
9Clinical Institute, University of Southern Denmark, Odense, Denmark.
Abstract
Purpose: Low-intensity extracorporeal shockwave therapy (LI-ESWT) is a potential novel treatment against diabetic kidney disease (DKD). The present study investigates the longer term effects of LI-ESWT on kidney function in patients with DKD.
Methods: This matched cohort study included 28 patients with DKD, who received six sessions of LI-ESWT. Patients were matched 1:5 with patients from the Funen Diabetes Database. Multivariable adjusted eGFR and ACR were analyzed using multilevel mixed-effects linear regression. The primary outcomes were ACR and eGFR measured at 3, 6, 12, and 18 month follow-up. Secondary analyses with patients stratified for sex, age, baseline eGFR, and baseline ACR were made for the multivariable adjusted values of eGFR and ACR.
Results: No significant difference in multivariable adjusted ACR or eGFR was found at 18 months. The intervention group showed a non-significant decrease in adjusted eGFR (1.83 mL/min/1.73 m2 lower, p = 0.15) and ACR (14%, p = 0,56). Stratified results revealed lower eGFR in patients > 60 years 3.64 mL/min/1.73 m2, p = 0.03) and those with baseline ACR ≤ 300 mg/g (3.64 mL/min/1.73, p = 0.007).
Conclusion: LI-ESWT did not demonstrate overall statistically significant effects on eGFR and ACR at 3, 6, 12, or 18 months. However, secondary analyses suggest possible effects in certain subgroups. Clinical studies with larger samples are needed to clarify the efficacy of LI-ESWT in specific DKD patient subgroups. Trial Registration The trial was prospectively registered July 31, 2015, at ClinicalTrials.gov with registration number NCT02515461.
Int Urol Nephrol. 2025 Feb 12. doi: 10.1007/s11255-025-04379-4. Online ahead of print. PMID: 39934556
Comments 1
IO do not understand enough from DKD to make a meaningful comment to the outcomes of this well documented study. When I first heard about some of the results of this project, I wondered if there was a more progressive form of DKD than what was seen in the patient groups evaluated here, and whether the effects of LISWT in such a group would have shown a different effect more quickly.
Peter Alken