Pretreatment with low‐energy (12 kV) shockwave lithotripsy (SWL) protects kidney from subsequent high‐energy application Free

A clinical dose of 2000 shockwaves applied at 12 kV induces renal vasoconstriction but causes no hemorrhagic lesion. Two thousand shockwaves applied at 24 kV causes the same vasoconstriction as 12 kV but lesion size is increased. These findings led us to ask whether lesion size would be smaller after 2000 shockwaves at 24 kV to one pole if a vasoconstrictive state was induced in that kidney by first applying 2000 shockwaves at 12 kV to the lower pole of that kidney. Anesthetized pigs received 2000 shockwaves to the lower pole followed by 2000 shockwaves to the upper pole of the same kidney. Structural and functional analyses were performed 4 hours post‐SWL. Results from these experiments show renal vasoconstriction induced from the first application of SWL at 12 kV to one pole appears to limit bleeding/hemorrhage caused by 24 kV to the other pole.