OBJECTIVES To assess the ideal interval between repeated shockwaves lithotripsy (SWL) for renal stones. PATIENT AND METHODS Eligible patients with a single renal stone ≤20 mm who required SWL were randomly assigned to one of three groups based on intervals between 1st and 2nd sessions. Patients underwent the 2nd session after 3, 7, and 14 days in groups 1, 2, and 3 respectively. Tubular functions were assessed through comparisons of urinary execration of Kidney Injury Molecule-1 (KIM-1), Neutrophil Gelatinase Associated Lipocalin (NGAL), and Interleukin-18 (IL-18) with pre-SWL values. While glomerular function was assessed by comparisons of protein/creatinine ratio with pre-SWL and changes in ipsilateral renal function on isotope scans. Treatment success was assessed by non-contrast CT after 3 months. RESULTS All demographics of the 166 patients included in the study were comparable between the three groups. There were significant elevations of tubular biomarkers and protein/creatinine ratio after 1st and 2nd SWL sessions when compared to pre-SWL values (P<0.0001). All tubular biomarkers returned to pre-SWL values at 7 and 14 days after second session while they remained significantly elevated 3 days after second session (P=0.027, <0.001 and <0.001 for KIM-1, NGAL, and IL-18 respectively). SWL success was 73.6% in Group 1, 83.7% in Group 2, and 81% in Group 3. A significant decrease in ipsilateral renal split function was observed in group 1 at the 3-month follow-up. CONCLUSIONS An interval of 7 days is required between SWL sessions when treating renal stones to allow for complete recovery of kidney functions.

中文翻译：

---

肾结石重复冲击波碎石疗程之间的理想间隔：随机对照试验。

目的 评估肾结石重复冲击波碎石术 (SWL) 之间的理想间隔。患者和方法 根据第 1 次和第 2 次疗程之间的间隔，将符合条件的单颗肾结石≤20 mm、需要 SWL 的患者随机分配到三组中的一组。第 1 组、第 2 组和第 3 组患者分别在 3、7 和 14 天后接受了第二次治疗。通过比较肾损伤分子 1 (KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白 (NGAL) 和白细胞介素 18 (IL-18) 的尿排泄量与 SWL 前的值来评估肾小管功能。通过比较 SWL 前的蛋白质/肌酐比以及同位素扫描中同侧肾功能的变化来评估肾小球功能。3 个月后通过平扫 CT 评估治疗是否成功。结果 研究中纳入的 166 名患者的所有人口统计数据在三组之间具有可比性。与 SWL 前的值相比，第 1 次和第 2 次 SWL 疗程后肾小管生物标志物和蛋白质/肌酐比值显着升高（P<0.0001）。所有肾小管生物标志物在第二次治疗后 7 和 14 天恢复到 SWL 前的值，而在第二次治疗后 3 天仍显着升高（KIM-1、NGAL 和 IL-18 分别为 P=0.027、<0.001 和 <0.001） 。第 1 组的 SWL 成功率为 73.6%，第 2 组为 83.7%，第 3 组为 81%。在 3 个月的随访中，观察到第 1 组同侧肾分裂功能显着下降。结论 治疗肾结石时，SWL 疗程之间需要间隔 7 天，以便肾功能完全恢复。