title: Effect of renal shock wave lithotripsy on the development of metabolic syndrome in a juvenile swine model: a pilot study.
abstract: OBJECTIVE
  We performed a pilot study to assess whether renal shock wave lithotripsy influences metabolic syndrome onset and severity.
  
  
  METHODS
  Three-month-old juvenile female Ossabaw miniature pigs were treated with shock wave lithotripsy (2,000 shock waves at 24 kV with 120 shock waves per minute in 2) or sham shock wave lithotripsy (no shock waves in 2). Shock waves were targeted to the upper pole of the left kidney to model treatment that would also expose the pancreatic tail to shock waves. Pigs were then instrumented to directly measure arterial blood pressure via an implanted radiotelemetry device. They later received a hypercaloric atherogenic diet for about 7 months. Metabolic syndrome development was assessed by the intravenous glucose tolerance test.
  
  
  RESULTS
  Metabolic syndrome progression and severity were similar in the sham treated and lithotripsy groups. The only exception arterial blood pressure, which remained relatively constant in sham treated pigs but began to increase at about 2 months towards hypertensive levels in lithotripsy treated pigs. Metabolic data on the 2 groups were pooled to provide a more complete assessment of metabolic syndrome development and progression in this juvenile pig model. The intravenous glucose tolerance test revealed substantial insulin resistance with impaired glucose tolerance within 2 months on the hypercaloric atherogenic diet with signs of further metabolic impairment at 7 months.
  
  
  CONCLUSIONS
  These preliminary results suggest that renal shock wave lithotripsy is not a risk factor for worsening glucose tolerance or diabetes mellitus onset. However, it appears to be a risk factor for early onset hypertension in metabolic syndrome.
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 Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Ziyue
authors.initials: Z
authors.lastname: Liu
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 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: David P
authors.initials: DP
authors.lastname: Basile
authors.affiliation: Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Johnathan D
authors.initials: JD
authors.lastname: Tune
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 Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Evan
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; D004195:Disease Models, Animal; D005260:Female; D008096:Lithotripsy / Q000009:adverse effects*; D024821:Metabolic Syndrome / Q000209:etiology*; D010865:Pilot Projects; D012306:Risk; D013552:Swine; D013556:Swine, Miniature
keywords: hypertension; kidney; lithotripsy; metabolic syndrome X; risk