[Clinical study of influential factors on renal scarring after ESWL monotherapy for renal stone disease].
OBJECTIVE
ESWL is now widely used for the treatment of renal stone disease. Although ESWL has many advantages for patients' quality of life, few reports have demonstrated the long-term outcomes of the alterations of renal morphology after ESWL. We reported renal scarring after ESWL monotherapy in patients with renal calyceal stones. In this study, we evaluated a large series of patients' cohort treated at our institution, and assessed the causal effect of ESWL on the late occurrence of renal scar formation.


METHODS
ESWL was performed with EDAP (LT-01,02) that generates shock wave energy by piezoelectric discharge. We analyzed the records of 285 kidneys treated between Dec. 1986 and Nov. 1998. Renal scarring was noted in 44 kidneys and not in 241 kidneys with periodical ultrasonography. We compared the backgrounds of the two groups using chi-square or non-parametric analysis. The Kaplan-Meier method and Cox regression model determined the analysis of renal scar formation.


RESULTS
Univariate and multiple regression analysis revealed that the total amount of ESWL emission and hyperuricemia independently affected the probability of renal scar formation.


CONCLUSIONS
Over-emission of ESWL (over 10,000 shots) must be care for the prevention of renal scarring in patients with renal calyceal calculi, especially when associated with hyperuricemia. After ESWL, periodical checkups with ultrasonography will provide useful information for the clinical diagnosis of renal scarring.
Ishito
Noritaka
N
Department of Urology, Kurashiki Medical Center.
Takamoto
Hitoshi
H
Kunitomi
Kimito
K
Satoh
Eiichi
E
Ishii
Ayano
A
Shiotuka
Youichi
Y
Sako
Shinichi
S
Ohta
Naoki
N
Araki
Tohru
T
D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033461:Hyperuricemia / Q000209:etiology; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D014463:Ultrasonography