Abstract
Shock wave lithotripsy (SWL) is widely viewed as an effective noninvasive method to break stones within the kidney and ureter. However, it is a technology that is not without trauma to the kidney--acute vascular, tubular and interstitial damage is often reported that if severe enough can lead to renal fibrosis (scarring) and permanent loss of functional parenchyma. These chronic changes can potentially lead to serious long-term adverse effects. The risk of developing chronic fibrotic lesions after lithotripsy is influenced by the number of shock waves (SWs) administered, SW power, rate of SW delivery and the number of SWL treatment sessions. The interplay between these risk factors is largely unknown, but progress has been made in identifying SWL protocols and pharmacologic therapies that can ameliorate the acute and chronic tissue damage that is an unintended consequence of SWL treatment.
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