[Extracorporeal shock-wave lithotripsy induced ultrastructural changes to the renal parenchyma under aspirin use. Electron microscopic findings in the rat kidney].
BACKGROUND
The risk of hemorrhagic complications after extracorporeal shock-wave lithotripsy (ESWL) increases in patients with aspirin intake, but the hematoma-inducing mechanism has not been understood completely at the ultrastructural level.


METHODS
The effect off shock-waves on the kidneys of male Wistar-rats (n=24) was investigated in an experimental setting using a special ESWL device. Ultrastructural examination was performed by light-, transmission electron- and scanning electron microscopy.


RESULTS
Shock-wave induced tissue damage appeared in all kidneys independently of aspirin intake. Endothelial detachment, lethal cell injury, gaps and mechanical disruption of the glomerular basement membrane were regularly found. After 1 week, repair processes were completed with evidence of permanent fibrosis in some cases.


CONCLUSIONS
ESWL can induce modest as well as fatal damage to renal tissue cells. Therefore, after an ESWL-induced hematoma a second ESWL should not be performed within 1 week of the first treatment.
Fischer
C
C
Klinik für Urologie und Kinderurologie, Klinikum Bayreuth GmbH, Bayreuth. claus.fischer@chiru.med.uni-giessen.de
Wöhrle
J
J
Pastor
J
J
Morgenroth
K
K
Senge
T
T
D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D001241:Aspirin / Q000633:toxicity*; D002198:Capillary Fragility / Q000187:drug effects; D005343:Fibrinolytic Agents / Q000633:toxicity*; D005355:Fibrosis; D006406:Hematoma / Q000139:chemically induced* / Q000473:pathology; D007668:Kidney / Q000187:drug effects / Q000293:injuries* / Q000473:pathology; D007678:Kidney Glomerulus / Q000187:drug effects / Q000293:injuries / Q000473:pathology; D007684:Kidney Tubules / Q000187:drug effects / Q000293:injuries / Q000473:pathology; D008096:Lithotripsy / Q000009:adverse effects* / Q000295:instrumentation; D008297:Male; D008855:Microscopy, Electron, Scanning; D046529:Microscopy, Electron, Transmission; D011292:Premedication; D051381:Rats; D017208:Rats, Wistar
D005343:Fibrinolytic Agents; D001241:Aspirin