Background: Acute kidney injury (AKI) may result from the treatment of nephrolithiasis with extracorporeal shockwave lithotripsy (SWL), but the incidence and outcome in dogs is unknown.
Objectives: To report the incidence and outcome of AKI in dogs treated with SWL and to identify any risk factors.
Animals: Fifty-one dogs, 57 treatments.
Methods: Retrospective, single center case series. Medical records from dogs with nephroliths and/or proximal ureteroliths treated with SWL between May 2011 and May 2024 were reviewed. Incidence of AKI was compared between water bath and dry SWL. Cases treated with dry SWL were assessed for risk factors of AKI.
Results: Incidence of AKI was significantly higher with dry SWL (10/32 treatments, 31%) versus water bath SWL (2/25 treatments, 8%; P=.049). AKI was graded as International Renal Interest Society grade I (n=7), grade II (n=2), and grade III (n=3). Serum creatinine returned to baseline in 10/12 (83%) cases. In the cohort treated with dry SWL, dogs with AKI had significantly lower pretreatment creatinine concentrations and lower maximum number of shocks on one kidney compared to dogs without AKI (P=.003 and P=.007, respectively). No difference was found with total number of shocks, power setting, maximum stone size, unilateral vs. bilateral treatment, pre-existing chronic kidney disease, hypotension, or anesthesia duration.
Conclusions and Clinical Importance: AKI is more likely with dry SWL but is usually transient. Further studies are needed to see if the relationship between AKI and pretreatment creatinine and number of shocks on one kidney persist in other cohorts.
