title: Shock wave lithotripsy targeting of the kidney and pancreas does not increase the severity of metabolic syndrome in a porcine model.
abstract: OBJECTIVE
  We determined whether shock wave lithotripsy of the kidney of pigs with metabolic syndrome would worsen glucose tolerance or increase the risk of diabetes mellitus.
  
  
  METHODS
  Nine-month-old female Ossabaw miniature pigs were fed a hypercaloric atherogenic diet to induce metabolic syndrome. At age 15 months the pigs were treated with 2,000 or 4,000 shock waves (24 kV at 120 shock waves per minute) using an unmodified HM3 lithotripter (Dornier MedTech, Kennesaw, Georgia). Shock waves were targeted to the left kidney upper pole calyx to model treatment that would also expose the pancreatic tail to shock waves. The intravenous glucose tolerance test was done in conscious fasting pigs before lithotripsy, and 1 and 2 months after lithotripsy with blood samples taken for glucose and insulin measurement.
  
  
  RESULTS
  Pigs fed the hypercaloric atherogenic diet were obese, dyslipidemic, insulin resistant and glucose intolerant, consistent with metabolic syndrome. Assessments of insulin resistance, glucose tolerance and pancreatic β cell function from fasting plasma glucose and insulin levels, and the glucose and insulin response profile to the intravenous glucose tolerance test were similar before and after lithotripsy.
  
  
  CONCLUSIONS
  The metabolic syndrome status of pigs treated with shock wave lithotripsy was unchanged 2 months after kidney treatment with 2,000 high amplitude shock waves or overtreatment with 4,000 high amplitude shock waves. These findings do not support a single shock wave lithotripsy treatment of the kidney as a risk factor for the onset of diabetes mellitus.
authors.affiliation: Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: rajash_handa@hotmail.com.
authors.forename: Rajash K
authors.initials: RK
authors.lastname: Handa
authors.affiliation: Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Evan
authors.affiliation: Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Bret A
authors.initials: BA
authors.lastname: Connors
authors.affiliation: Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Cynthia D
authors.initials: CD
authors.lastname: Johnson
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Ziyue
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Mouhamad
authors.initials: M
authors.lastname: Alloosh
authors.affiliation: Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Michael
authors.initials: M
authors.lastname: Sturek
authors.affiliation: Department of Medicine and Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Carmella
authors.initials: C
authors.lastname: Evans-Molina
authors.affiliation: Kidney Stone Institute of Indiana University Health Methodist Hospital, Indianapolis, Indiana.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Mandeville
authors.affiliation: Kidney Stone Institute of Indiana University Health Methodist Hospital, Indianapolis, Indiana.
authors.forename: Ehud
authors.initials: E
authors.lastname: Gnessin
authors.affiliation: Kidney Stone Institute of Indiana University Health Methodist Hospital, Indianapolis, Indiana.
authors.forename: James E
authors.initials: JE
authors.lastname: Lingeman
mesh_terms: D000818:Animals; D003921:Diabetes Mellitus, Experimental / Q000209:etiology* / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D007669:Kidney Calculi / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D008096:Lithotripsy / Q000009:adverse effects* / Q000379:methods; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D010179:Pancreas; D012720:Severity of Illness Index; D013552:Swine
keywords: diabetes mellitus; kidney; lithotripsy; metabolic syndrome X; risk