Shock Wave Therapy Linked to Diabetes, Hypertension

[Angel]

Shock wave therapy for kidney stones could lead to diabetes and hypertension later in life, according to a new study from Mayo Clinic researchers in Rochester, Minn. The study shows a strong link between shock wave lithotripsy and a significant risk for diabetes and hypertension later in life.

Shock wave lithotripsy is a procedure doctors use to help break up kidney stones too large to be passed. The patient is placed in a water bath along with a shock wave-emitting device. The shock waves break the stone into smaller pieces that can then be eliminated through urine.

Researchers say they can't be certain the shock wave treatment actually causes the increased risk of diabetes and hypertension, but, they say the association is so high it leads to some big questions. The risk of developing diabetes after shock wave therapy is four times the risk for people whose kidney stones were treated with medicine. The risk of developing high blood pressure was 1.5-times higher for those who were treated with shock wave therapy compared to patients treated with medicine.

Researchers sent questionnaires to patients who received shock wave therapy in 1985 at Mayo Clinic. Among those who were still alive and responded, researchers found the increased risk for diabetes and high blood pressure was highest among those who had more intense shock wave therapy and a greater number of treatments.

The researchers theorize the increased risk for diabetes may come from damage to the pancreas. Islet cells in the pancreas make insulin. Scarring on the kidneys, which may affect the kidneys' ability to produce blood pressure-influencing hormones like rennin, may cause the increased risk for high blood pressure.

The researchers do not suggest ending the use of shock wave therapy, rather they urge doctors to fully explain all risks, including diabetes and hypertension, when talking to patients about shock wave therapy.