Wu Q. et al., 2021: Association between renal urolithiasis after extracorporeal shock wave lithotripsy therapy and new-onset hypertension: an updated meta-analysis.
Wu Q, Liang R, Huang Y, Tan C, Zhu G, Chen Y, Cao L, Zou B, Li X, Wang H, Wang X, Tang T, Wu T.
Department of Urology, Affiliated Hospital of Sichuan Medical College, Nanchong, China.
Department of Medical Imaging, Affiliated Hospital of Sichuan Medical College, Nanchong, China.
Objective: The long-term effect of extracorporeal shock wave lithotripsy (SWL) is still controversial. A previous meta-analysis showed no association between new-onset hypertension and entire upper urinary urolithiasis after SWL. Recently, there have been some reports on this topic. Therefore, we aimed to examine the association between new-onset hypertension and nephrolithiasis after SWL therapy.
Methods: Embase, the Cochrane Central Search Library, and PubMed were used to search for reports on new-onset hypertension and patients with nephrolithiasis after SWL. A meta-analysis of the association between new-onset hypertension and nephrolithiasis after SWL was carried out. The data of relevant research were synthesized and the relative risk was computed.
Results: Seven eligible studies were included in our meta-analysis. There was a significant association between nephrolithiasis after SWL and new-onset hypertension. The overall relative risk with a 95% confidence interval was 1.21 (1.11-1.31) in a fixed-effects model.
Conclusion: Our meta-analysis suggests an association between new-onset hypertension and patients with nephrolithiasis after SWL, which is in contrast with the finding of a previous meta-analysis.
J Int Med Res. 2021 Apr;49(4):3000605211002003. doi: 10.1177/03000605211002003. PMID: 33794678. FREE ARTICLE
Hypertension after ESWL is a waxing and waning story and it is obviously difficult to prove it and to find truly comparable groups.
Why would the authors add, “We suggest that readers interpret our results with caution” and “We cannot attribute only new-onset hypertension to SWL”?
Data on hypertension after ESWL and in control groups listed in the present meta-analysis
If all authors of the different publications are talking about the same subject and compare apples with apples then it makes sense to bring them together in a metaanalysis. Moreover, if it is all about apples and if “there was no significant heterogeneity among the included studies”, why is there a large variation within the values of the two single groups, ESWL and controls? And if it would not be all mathematics, comparing the highest value of the controls with the lowest value of the ESWL group offers a surprise result. However, this is not scientific as they are not comparable. It is not all apples.