Frequency of stone clearance after extracorporeal shockwave lithotripsy for renal stones in adult patients with renal insufficiency

Abstract

Objective: To determine the rate of stone clearance after extracorporeal shockwave lithotripsy (ESWL) for renal stones in adult patients with renal insufficiency. Subjects and methods: This is a cross-sectional descriptive study of 117 adult patients who underwent ESWL. The indications for ESWL were determined by the stone size and serum creatinine. All adult patients including males and females (≥18 years) with renal stones ≤2 cm in size and serum creatinine between 1.5–5.0 mg/dl were included in the study. All patients underwent ureteral double J (DJ) stent placement before ESWL. The initial success of treatment was assessed on the basis of plain radiographic imaging and ultrasonography which was performed 1 month after ESWL. Final stone clearance was evaluated at 3 months after the first ESWL session. Data were analyzed using SPSS version 18.0. Results: A total of 117 patients underwent ESWL in this study. Out of these, 88 (75.2%) were males and 29 (24.8%) females with a male to female ratio of 3.0:1. The mean age was 38.2 ± 14.1 years. The mean serum creatinine and stone size were 2.4 ± 0.8 mg/dl and 1.4 ± 0.3 cm, respectively. The overall frequency of stone clearance after ESWL for renal stones was 70.9% (83/117) in patients with renal insufficiency. The rate of stone clearance was 76.4% (42/55) in cases with serum creatinine of 1.5–2 mg/dl, 69% (20/29) in patients with serum creatinine of 2.1–3 mg/dl, 70.4% (19/27) in patients with serum creatinine of 3.1–4 mg/dl and 33.3% (2/6) in those with serum creatinine of 4.1–5 mg/dl (p = 0.175). Conclusion: Our results show that ESWL may be used as the first line of management for renal stones in patients with mild to moderate renal insufficiency.

Keywords

• Renal stone
• Extracorporeal shockwave lithotripsy
• Serum creatinine
• DJ stent