Diabetes From Kidney Stone Blaster?
Nearly 4 Times Higher Diabetes Risk After Shock Wave Treatment for Kidney Stones
April 10, 2006 -- Pulverizing kidney stones with shock waves raises a
person's risk of diabetes and high blood pressure, a new study shows.
In the early 1980s, getting a often meant painful open surgery.
Then came . This revolutionary technology uses sonic waves to blast
kidney stones into tiny grains of sand. No surgery is needed.
It's always seemed to be safe. But now there's disturbing new data from a
Mayo Clinic study. The study appears in the May issue of the Journal of
Shock Wave Damage
The study compared kidney stone patients treated in 1985 with shock wave
lithotripsy to patients given other nonsurgical kidney stone treatments that
same year. Nineteen years later, the shock wave patients were nearly four times
more likely to get diabetes. And, if both kidneys were treated, they were 47%
more likely to have high blood pressure.
It's not yet clear how shock wave treatment might cause these problems, says
researcher Amy E. Krambeck, MD. What seems to be happening is collateral damage
from the shock waves.
"The theory is that the shear forces related to shock wave lithotripsy can
cause tissue damage," Krambeck tells WebMD. "Damage to the pancreas could put
patients at risk for diabetes."
Patients who got the most shock wave treatments -- at the highest intensity
- had the highest risk of diabetes.
Don't Suspend Treatment
The shock wave machine used in 1985 is an older model. It's still in use at
the Mayo Clinic, Krambeck says. Newer shock wave machines give a more focused
shock -- but also provide stronger shock waves. Because the Mayo study is the
first to link diabetes to shock wave treatment, it's not at all clear whether
newer machines provide less risk, the same risk, or more risk.
Krambeck says much more study is needed. In the meantime, she says, there's
no reason to stop using the machines for patients with large kidney stones.
There's no immediate danger for people who've had their kidney stones
treated by shock wave, says Glenn Preminger, MD. Preminger chairs the American
Urological Association's kidney stone treatment panel. He's professor of
urologic surgery and director of the comprehensive kidney stone center at Duke
"Prudence -- and the need for surveillance -- is warranted," Preminger tells
WebMD. "But we do not need to suspend shock wave lithotripsy or rush to the
doctor at this point. Any stone-forming patients should have routine follow-up
with their physicians. As part of that routine care, we would look for the
possibility of high blood pressure and diabetes. So what I recommend is prudent
There are different kinds of kidney stones -- and different treatment
"There are 101 ways to form a kidney stone," Krambeck says. "It all has to
do with genetic makeup, diet, and lifestyle. Once a person forms a stone, he or
she needs a complete metabolic evaluation to understand why. Then we can give
medication to prevent a second stone."