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, espectively. 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.

African Journal of Urology (2017) 23, 219–223