Abstract
SWL to one kidney causes localized tissue damage and impairment of tubular function, but reduces renal plasma flow (RPF) in both kidneys. We examined the effect of SWL voltage (kV) and inversion of the waveform (IW) on these localized and bilateral effects of SWL. Five-week-old pigs were anesthetized for either sham-SWL or SWL (2000 shocks, unmodified HM3) at 12, 18, or 24 kV or 2000 shocks, 24 kV, with a reflector that inverts the waveform. RPF and tubular extraction of PAH (EPAH) were measured 1 h before and 1 and 4 h after SWL. EPAH estimates tubular secretion function. SWL significantly reduced RPF to similar degrees at each kV. EPAH was not significantly reduced in the 12-kV group, but was reduced to progressively greater degrees in the 18 and 24 kV groups. IW eliminated ultrasonic evidence of cavitation, produced minimal tissue damage, and eliminated the reduction of EPAH. It did not eliminate the reduction of RPF. The data suggest that shock-wave voltage and cavitation may be related to the tissue injury and reduced EPAH induced by SWL, but suggests that neither may be directly related to the impairment of RPF. [Work supported by NIH, PO1 DK43881.]
Published Version
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