Preliminary report on the functional changes associated with burst wave lithotripsy treated pig kidneys

Burst Wave Lithotripsy (BWL) is a new stone treatment that utilizes ultrasound to fracture renal calculi. However, it is not known if BWL alters renal function, so we tested if a clinical dose of BWL impacts glomerular filtration rate (GFR) or kidney blood flow. Treatment consisted of placing each pig (32–42 kg) on its side, locating the lower pole of the right kidney, and treating that kidney with a BWL dose of 18,000 ultrasound pulses at 10Hz, 20 cycles/pulse and a peak negative pressure of −7 MPa (n = 6). Six additional pigs were used as sham controls. Inulin and para-aminohippuric acid (PAH) were infused into the pigs with blood and urine samples being collected both before and 1-h after BWL treatment. The concentrations of inulin and PAH were determined in the samples and used to calculate GFR and effective renal plasma flow (eRPF). For the BWL treated group, GFR and eRPF did not change after BWL exposure (−6.7 ± 7.2% for GFR, −10.9 ± 5.5% for eRPF), and this response was like the sham control group ( P = 0.23 for GFR, P = 0.08 for eRPF). A typical clinical dose of BWL caused no change in renal function. [Work supported by NIH, Grant P01 DK43881.]