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Kidney Stone Treatment and Diabetes

People getting treatment for kidney stones may do well to think first before undergoing a common treatment to remove kidney stones. A new study done by Mayo Clinic researchers found that shock wave lithotripsy, which uses shock waves to break up kidney stones into smaller pieces, significantly increases the risk for diabetes and hypertension later in life. The study identifies the intensity of the treatment and quantity of the shock waves administered as the possible causes of increased diabetes risk, while the hypertension risk can be attributed to the treatment of stones in both kidneys.

Researchers say that they cannot be 100 percent sure that shock wave treatment for kidney stones causes diabetes and hypertension, but states that the association is very strong. “The risk of developing diabetes after shock wave lithotripsy is almost four times [greater than] the risk of people with kidney stones treated with medicine [alone], and the risk of developing hypertension is one and one-half times, which is a significant risk,” says Dr. Amy Krambeck, lead study investigator and a urologist at Mayo Clinic.

Using questionnaires sent to patients who received shock wave lithotripsy in 1985 at Mayo Clinic, the researchers found that nineteen years after the treatment, those treated with lithotripsy had 3.75 times greater risk of developing diabetes and 1.47 times increased risk for hypertension or high blood pressure compared to those given other treatment for kidney stones.The risk increased even more with greater number and intensity of shocks administered, and was highest for those who had both kidneys treated.

Study investigators hypothesize that lithotripsy may affect the islet cells in the pancreas that make insulin,which may explain the increased risk for diabetes. Shock wave therapy may also scar the kidneys and this may alter the secretion of hormones in the kidneys like renin, which influence blood pressure.

Despite the risks, shock wave lithotripsy continues to be used as a treatment option for kidney stones. Researchers say that other treatments for kidney stones are associated with their own sets of risks too, and that it is up to the patients to decide whether the risks are worth taking.

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