Abstract
Low‐energy extracorporeal shock wave therapy (SWT) has been shown to improve myocardial dysfunction, hind limb ischemia, erectile function, and to facilitate cell therapy and healing process. These therapeutic effects were mainly due to promoting angiogenesis. Since chronic kidney diseases are characterized by renal fibrosis and capillaries rarefaction, they may benefit from a proangiogenic treatment. The objective of our study was to determine whether SWT could ameliorate renal repair and favor angiogenesis in L‐NAME‐induced hypertensive nephropathy in rats. SWT was started when proteinuria exceeded 1 g/mmol of creatinine and 1 week after L‐NAME removal. SWT consisted of implying 0.09 mJ/mm2 (400 shots), 3 times per week. After 4 weeks of SWT, blood pressure, renal function and urinary protein excretion did not differ between treated (LN + SWT) and untreated rats (LN). Histological lesions including glomerulosclerosis and arteriolosclerosis scores, tubular dilatation and interstitial fibrosis were similar in both groups. In addition, peritubular capillaries and eNOS, VEGF, VEGF‐R, SDF‐1 gene expressions did not increase in SWT‐treated compared to untreated animals. No procedural complications or adverse effects were observed in control (C + SWT) and hypertensive rats (LN + SWT). These results suggest that extracorporeal kidney shock wave therapy does not induce angiogenesis and does not improve renal function and structure, at least in the model of hypertensive nephropathy although the treatment is well tolerated.
Highlights
Ultrasounds are commonly used for medical imaging, but ultrasounds have various therapeutic applications too
Other glomeruli were collapsed with enlarged urinary chamber; (2) microvascular lesions ranging from arteriolar wall thickening to onion skin proliferation with complete obliteration and to fibrinoid necrosis of the vascular wall; (3) tubular atrophy and dilatation; and (4) a mild interstitial fibrosis (Fig. 3)
This study investigated for the first time, the impact of shock wave therapy (SWT) on renal repair and angiogenesis in the L-NAME model of nephropathy
Summary
Ultrasounds are commonly used for medical imaging, but ultrasounds have various therapeutic applications too. Shock wave is a longitudinal acoustic wave, travelling through body tissue with the speed of ultrasound in water. It is a single pressure pulse with a short needle-like positive spike
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