Effects of Nifedipine and Allopurinol on Acute Changes of Renal Function after Piezoelectric Extracorporeal Shock Wave Lithotripsy

Ahn, Seung Hyeun; Moon, Young Tae; Cha, Young Joo

Abstract

We evaluate the effects of a calcium antagonist(nifedipine) and a xanthine oxidase inhibitor (allopurinol), drugs having a protective effect against shock wave induced renal dysfunction, on acute changes of renal function after piezoelectric ESWL. A total of 40 patients with renal stones undergoing piezoelectric ESWL with LT02 lithotriptor was randomly assigned to 4 groups. Group 1 received no medication and the others received nifedipine(group 2), allopurinol(group 3), and nifedipine plus allopurinol(group 4), respectively. NAG, LDH, 7-GTP, D2M, and microalbumin were measured in the 24-hour urine before and after ESWL. Baseline levels of these parameters were not statistically different between the control group and the others. After ESWL, NAG and microalbumin were significantly increased in group l(p<0.01). In groups 2 and 4, all of the parameters after ESWL were not significantly different from the Values before ESWL. Although the level of NAG after ESWL was significantly higher(p<0.01) than that of the pre-ESWL in group 3, the change of NAG was milder in group 3 comparing to group 1. The range of increase of NAG in groups 2 and 4 were significantly low(<0.01) compared to group 1, and the range of increase of microalbumin in groups 2, 3, 4 were significantly low compared to group l(group 2, 4; p<0.01, group 3; p<0.05). Our results indicate that nifedipine and/or allopurinol can prevent or decrease acute changes of renal function after ESWL using LT02 piezoelectric lithotriptor and especially nifedipine seems to be more efficient than allopurinol.