Renal shock wave lithotripsy may be a risk factor for early-onset hypertension in metabolic syndrome: A pilot study in a porcine model

Abstract

A pilot study was conducted to assess whether extracorporeal shock wave lithotripsy (SWL) treatment of the kidney influences the onset and severity of metabolic syndrome (MetS)—a cluster of conditions that includes central obesity, insulin resistance, impaired glucose tolerance, dyslipidemia, and hypertension. Methods: Three-month-old juvenile female Ossabaw miniature pigs were treated with either SWL (2000 SWs, 24 kV, 120 SWs/min using the HM3 lithotripter; n = 2) or sham-SWL (no SWs; n = 2). SWs were targeted to the upper pole of the left kidney so as to model treatment that would also expose the pancreas—an organ involved in blood glucose homeostasis—to SWs. The pigs were then instrumented for direct measurement of arterial blood pressure via implanted radiotelemetry devices, and later fed a hypercaloric atherogenic diet for ~7 months to induce MetS. The development of MetS was assessed from intravenous glucose tolerance tests. Results: The progression and severity of MetS were similar in the sham-treated and SWL-treated groups. The only exception was arterial blood pressure, which remained relatively constant in the sham-treated pigs and rose toward hypertensive levels in SW-treated pigs. Conclusions. These preliminary results suggest that renal SWL appears to be a risk factor for early-onset hypertension in MetS.