Assessment of Sympathetic Activity of Adrenal Medullae in Patients with Kidney Stone Treated by Extracorporeal Shock Wave Lithotripsy (ESWL)

Abstract

Background: Extracorporeal shock wave lithotripsy (ESWL) is the most widely used method for treating kidney and upper ureteric stones smaller than 2 cm due to its effectiveness, safety, non-invasive, and an outpatient procedure. Objective: The present study aims to assess the effect of ESWL on the sympathetic activity of adrenal medullae in patients with renal stone. Materials and Methods: A cross-sectional study was conducted at the ESWL Unit, AL-Hilla Teaching Hospital, Babil Province, Iraq on 50 patients from October 1, 2021 to April 30, 2022. Before and right after an ESWL session, patients underwent a history, physical examination and laboratory tests to measure their levels of serum catecholamines (CAs). Results: The results of this study revealed that there is a significant increase of serum epinephrine and norepinephrine levels (P-value <0.001) after ESWL session. There is a significant (P <0.1) increase in epinephrine and norepinephrine levels in patients treated for upper pole renal stones when compared with mid and lower pole renal stones after having an ESWL session. Changing the lithotripter’s parameters (energy, frequency, and number of shock waves) did not significantly (P > 0.05) correlate with the level of both norepinephrine and epinephrine in the serum after the ESWL session. Conclusion: The study found that patients with renal stones treated with ESWL had elevated serum CA levels after the session. The CA level correlates with the site of stone (the stone comes near to the adrenal medullae as there was an increase in the CA level), whereas it was unaffected by the lithotripter’s parameters.