title: [Extracorporeal shock-wave lithotripsy induced ultrastructural changes to the renal parenchyma under aspirin use. Electron microscopic findings in the rat kidney].
abstract: 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.
authors.affiliation: Klinik für Urologie und Kinderurologie, Klinikum Bayreuth GmbH, Bayreuth. claus.fischer@chiru.med.uni-giessen.de
authors.forename: C
authors.initials: C
authors.lastname: Fischer
authors.forename: J
authors.initials: J
authors.lastname: Wöhrle
authors.forename: J
authors.initials: J
authors.lastname: Pastor
authors.forename: K
authors.initials: K
authors.lastname: Morgenroth
authors.forename: T
authors.initials: T
authors.lastname: Senge
mesh_terms: 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
chemical_list: D005343:Fibrinolytic Agents; D001241:Aspirin