Accumulated renal damage due to repeat extracorporeal shock wave lithotripsy in rabbits

Objective To establish the accumulated kidney damage animal model induced by multiple and Repeat extracorporeal shock wave lithotripsy(ESWL),explore the digital times-effect relations between ESWL and accumulated kidney damage,and guide the clinical treatment of renal calculi hope to reduce renal damage and prevent severe renal function damage. Methods A total of 72 male adult rabbits were randomly divided into 6 groups according to the times of ESWL.The renal pelvis or calyx(on the basis of real-life condition of recurrent kidney stones) was randomly selected to perform ESWL with HK.ESWL-V lithotripter.The levels of Cr,GGT and NAG in urine were tested before and after ESWL.The renal arterial resistive index(RI) was measured with color Doppler flow imaging(CDFI) before and after ESWL. Results ①The levels of urine Cr,r-GT and NAG increased in all trial groups,and increased gradually with ESWL times.There was significant difference in urine Cr,r-GT and NAG between the trial groups and control group.②ESWL increased the resistance of renal blood flow,which was significant difference between each experimental group(P<0.001).The average renal vascular resistance index(RI) increased with ESWL times. Conclusion The characteristics of recurrent stone positions changes can be accurately and veritably simulated by using rabbits ESWL random site model.The multiple and repeat ESWLs can cause penetrating damage on kidney with fiberization accumulatively.The times of ESWL to ipsilateral kidney should be strictly controlled according to the clinical indications.The parameters of ESWL should be changed based on the feature of stones to prevent the accumulated damage of kidney due to ESWL and protect renal function as possible.