BLOOD-PRESSURE CHANGES AFTER EXTRACORPOREAL SHOCK-WAVE NEPHROLITHOTRIPSY - PREDICTION BY INTRARENAL RESISTIVE INDEX

In order to identify a high-risk group for the development of arterial hypertension after extracorporeal shock wave nephrolithotripsy (ESWL) , we correlated the increase in renovascular resistance induced by ESW L in 79 normotensive patients with changes in arterial blood pressure occurring 20 (+/-3) months after therapy. Renal vascular resistance wa s measured as resistive index (RI) by duplex Doppler sonograpy in both kidneys. Mean RI before treatment was 0.620+/-0.035 (SD). After treat ment, we observed a significant and age-dependent increase in the RI i n the treated kidney to 0.673+/-0.06. Of the patients with a post-ESWL RI > 0.690, 39% developed hypertension. Posttherapy RI values surpass ing 0.690 showed a 0.8 sensitivity and a 0.7 specificity in predicting arterial hypertension. Intrarenal Doppler ultrasound (US) is useful t o find the high-risk group for arterial hypertension after ESWL.