Light microscopic, immunofluorescent and electron microscopic evaluation of extracorporeal shock wave lithotripsy-induced acute renal lesions / 대한비뇨기과학회지

ABSTRACT

Biopsy material taken from kidneys of 9 patients with renal stones before extracorporeal shock wave lithotripsy (ESWL) and 5-10 days (average 7 days) of the ESWL was examined histologically and ultrastructurally. In the pre-ESWL specimens, no significant finding was found in the tubule and interstitium, except in one which showed mononuclear cell infiltration and tubular atrophy. In the post-ESWL specimens, light microscopy revealed edema, fibrosis and inflammation of interstitium in all specimens. In 6 specimens, detachment, degeneration and regeneration of tubular epithelium with destruction and atrophy of tubular basement membrane were seen. immunofluorescence study revealed no specific finding. Using the electron microscope, degeneration or proximal tubular epithelium and irregular thickening of tubular basement membrane were seen and there were dilatation of capillary edema, infiltration of chronic inflammatory cells and fibrosis in the interstitium. Loss of pseudopod of glomerular epithelial cells and irregular thickening of basement membrane were seen in the glomerulus. These results indicate that renal damage can be shown soon after ESWL on histological and ultrastructural studies and that the lesions observed can be either reversible or permanent.