Shock Wave Lithotripsy Is As Effective As Ureteroscopy in Treating Children With Kidney Stones And Has Better Quality Of Life
May 17, 2024
The AUA and European Association of Urology (EAU) guidelines recommend that children with kidney stones <20 mm and ureteral stones be treated with ureteroscopy (URS) or shock wave lithotripsy (SWL), but these recommendations are based on stone clearance rates There was low-level evidence (Level of Evidence: C) and no evidence from patient-reported outcomes (PROs). Although URS and SWL have the same weight in recommendations, 80% of children with kidney stones still receive URS in clinical practice.
Click to Cistanche for kidney disease
During 2020-2023, the Pediatric Kidney Stone Care Improvement Network (PKIDS) conducted a prospective observational trial in children aged 8-21 years at 30 medical centers in North America to compare URS and SWL in the kidney and ureter. Effects of application in stones. The primary study endpoint was a stone-free rate assessed by ultrasonography 6 (±2) weeks postoperatively. Secondary study endpoints were patient-reported outcomes (PROs) assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS) and urinary tract symptom scores at 1, 3, 6, and 12 weeks postoperatively.
The study included 1070 children who received URS and 197 children who received SWL. The age, gender, and race distribution of the two groups were consistent. The median stone size was 6 mm (IQR 4, 9) in the URS group and 7 mm (IQR 6, 9) in the SWL group.
After adjusting for differences between groups, for urinary tract stones of different locations and sizes (only 3 children in the SWL group had stones >15 mm, which could not be analyzed), the stone clearance rates of the URS and SWL groups were 74.5% (95% CI) respectively. 65.7, 83.3) and 68.6% (95% CI 59.7, 77.7), there was no statistically significant difference (risk difference [RD] = 5.9, 95% CI -6.6, 18.5).
Compared with URS, SWL reduced pain intensity, pain interference, and urinary tract symptoms one week after surgery. There were no differences in any PROs between the two treatment modalities from 3 weeks postoperatively to the final 3-month postoperative assessment.
Among children with renal and ureteral stones, SWL was associated with similar stone clearance rates and better patient-reported quality of life than URS. These results support the use of SWL therapy in children and adolescents with small to medium-sized urinary tract stones.
How Does Cistanche Treat Kidney Disease?
Cistanche is a traditional Chinese herbal medicine used for centuries to treat various health conditions, including kidney disease. It is derived from the dried stems of Cistanche deserticola, a plant native to the deserts of China and Mongolia. The main active components of cistanche are phenylethanoid glycosides, echinacoside, and acteoside, which have been found to have beneficial effects on kidney health.
Kidney disease, also known as renal disease, refers to a condition in which the kidneys are not functioning properly. This can result in a buildup of waste products and toxins in the body, leading to various symptoms and complications. Cistanche may help treat kidney disease ase through several mechanisms.
Firstly, cistanche has been found to have diuretic properties, meaning it can increase urine production and help eliminate waste products from the body. This can help relieve the burden on the kidneys and prevent the buildup of toxins. By promoting diuresis, cistanche may also help Reduce high blood pressure, a common complication of kidney disease.
Moreover, cistanche has been shown to have antioxidant effects. Oxidative stress, caused by an imbalance between the production of free radicals and the body's antioxidant defenses, plays a key role in the progression of kidney disease. ies help neutralize free radicals and reduce Oxidative stress, thereby protecting the kidneys from damage. The phenylethanoid glycosides found in cistanche have been particularly effective in scavenging free radicals and inhibiting lipid peroxidation.
Additionally, cistanche has been found to have anti-inflammatory effects. Inflammation is another key factor in the development and progression of kidney disease. Cistanche's anti-inflammatory properties help reduce the production of pro-inflammatory cytokines and inhibit the activation of inflammation mandatory pathways, thus alleviating inflammation in the kidneys.
Furthermore, cistanche has been shown to have immunomodulatory effects. In kidney disease, the immune system can be dysregulated, leading to excessive inflammation and tissue damage. Cistanche helps regulate the immune response by modulating the production and activity of immune cells, such as T cells and macrophages. This immune regulation helps reduce inflammation and prevent further damage to the kidneys.
Moreover, cistanche has been found to improve renal function by promoting the regeneration of renal tubes with cells. Renal tubular epithelial cells play a crucial role in the filtration and reabsorption of waste products and electrolytes. In kidney disease, these cells can be damaged, leading to damaged renal function. Cistanche's ability to promote the regeneration of these cells helps restore proper renal function and improve overall kidney health.
In addition to these direct effects on the kidneys, cistanche has been found to have beneficial effects on other organs and systems in the body. This holistic approach to health is particularly important in kidney disease, as the condition often affects multiple organs and systems. che has been shown to have protective effects on the liver, heart, and blood vessels, which are commonly affected by kidney disease. By promoting the health of these organs, cistanche helps improve overall kidney function and prevent further complications.
In conclusion, cistanche is a traditional Chinese herbal medicine used for centuries to treat kidney disease. Its active components have diuretic, antioxidant, anti-inflammatory, immunomodulatory, and regenerative effects, which help improve renal function and protect the kidneys from further damage. , cistanche has beneficial effects on other organs and systems, making it a holistic approach to treating kidney disease.
