EXAMINATION OF INTRARENAL BLOOD-FLOW BY DOPPLER ULTRASOUND BEFORE ANDAFTER EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY FOR UROLITHIASIS

This study was aimed to test whether therapeutical extracorporeal shoc k wave lithotripsy (ESWL) may induce changes in renal parenchymatous b lood flow, thereby indirectly indicating shock wave side effects on th e renal parenchyma. In 18 patients, a Duplex ultrasound investigation of both kidneys was performed before and after ESWL. Pulsatility Index (PI), which is an estimation of renovascular resistance, increased in both treated and untreated kidney. However, the increase was confined to a subgroup of seven patients, who had received meperidine (a morph ine analgetic) for analgesia. This increase is more likely to be due t o a pharmacological effect of meperidine rather than a direct effect o f ESWL on renal hemodynamics. In conclusion, we did not find any evide nce of ESWL related affection of renal blood now measured with duplex ultrasound, a technique sensitive enough to detect changes in renal he modynamics due to morphine analgetics.