EFFECTS OF EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY TO ONE-KIDNEY ON BILATERAL GLOMERULAR-FILTRATION RATE AND PAH-CLEARANCE IN MINIPIGS

Purpose: This study examined the acute time course of effects of extra corporeal shock wave lithotripsy (ESWL)(1) on renal hemodynamics in an esthetized minipigs with and without pretreatment with verapamil. Mate rials and Methods: We applied ESWL (2000 shocks, 24 kV, unmodified Dor nier HM3), to the right kidneys of isoflurane-anesthetized female pigs . Urine flow and renal hemodynamics were monitored from each kidney vi a ureteral balloon catheters. Arterial blood pressure and bilateral ur ine flow, glomerular filtration rate (GFR, inulin clearance) and renal plasma flow (RPF, para-aminohippurate clearance) were monitored for 4 5 minutes before ESWL, and at 1, 4 and 24 hours after ESWL. Results: T reatment with ESWL consistently caused unilateral hematuria and subcap sular renal hematomas in the shocked kidneys and significantly reduced GFR and RPF in those kidneys at 1 and 4 hours after ESWL. Urine flow was reduced through 24 hours in the shocked kidneys. Renal plasma flow , but not GFR, was significantly reduced in the contralateral (unshock ed) kidneys at 1 and 4 hours after ESWL to the other kidneys. Verapami l blunted the ESWL-induced reductions of urine flow, GFR and RPF in th e shocked kidneys and eliminated the reduction of RPF in the unshocked kidneys. Conclusions: These experiments demonstrate that ESWL to 1 ki dney acutely impaired hemodynamics in both kidneys and that verapamil attenuated the response in the shocked kidneys and eliminated it in th e contralateral unshocked kidneys.