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Shock Wave Therapy Increase The Risk Of Diabetes

g diabetes as those given the other kidney stone treatment. The degree of increased risk rose with greater number and intensity of shocks administered. Those treated with lithotripsy also had 1.47 times the risk of having hypertension -- high blood pressure -- than those who received the other kidney stone treatment; risk was highest for those who had both kidneys treated.

The researchers hypothesize that the increase in risk for diabetes associated with shock wave therapy for kidney stones relates to damage inflicted to the pancreas, a previously known risk of lithotripsy, which may affect the islet cells in the pancreas that make insulin. They believe the increased risk for hypertension may relate to scarring, which the treatment may cause to the kidneys and could alter the secretion of hormones centered in the kidneys like renin, which influence blood pressure.

Drs. Krambeck and Joseph Segura, M.D., Mayo Clinic urologist and study investigator, say that they continue to use shock wave treatment, among other alternative treatments for kidney stones.

“Despite the risks, shock wave therapy still can save the day for patients, and it would be a mistake to put it on the shelf,” says Dr. Segura.

The researchers indicate that they now counsel patients about the potential risk for diabetes and hypertension prior to shock wave treatment.

Dr. Segura stresses the need for kidney stone patients and their physicians to weigh the pros and cons of shock wave treatment according to individual situations. “It’s a trade-off about whether the risks are worth taking,” he says. “We’re assuming doing nothing is not the right thing to do for patients. You have to look at it in terms of treatment alternatives -- percutaneous stone removal [removing a kidney stone through a small incision in the patient’s back using an instrument called a nephroscope] or ureteroscopy [snaring a stone with a small instrument passed into the ureter through
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