Empiric therapy for kidney stones

Goldfarb, David S.

doi:10.1007/s00240-018-1090-6

Cited by 35 publications

(31 citation statements)

References 61 publications

(68 reference statements)

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“…Numerous reports in the literature on patients with urolithiasis refer to results of analysis of 24-h urine composition. An overwhelming number have shown that 24-h urinary risk factors for stone-formation are more frequently abnormal in stone forming patients than in normal controls [7,[19][20][21]. Reports also show that 24-h abnormalities provide useful information to help understand the underlying cause of stones in a given patient as well as for targeting changes in urine composition that should reduce his/her risk of stone recurrence.…”

Section: Q2 What Type Of Urine Collection Is Best For Assessing a Pamentioning

confidence: 99%

“…For example, a recent study of a large cohort within the United States (US) Veterans Affairs Health Care System found that fewer than 1-in-6 stone forming patients had undergone 24-h urine testing that would have been relevant to managing their urinary stone disease [5]. A possible interpretation of this low utilization of urine data is that physicians in the US are unconvinced that urine testing is valuable and cost-effective [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Urine and stone analysis for the investigation of the renal stone former: a consensus conference

et al. 2020

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The Consensus Group deliberated on a number of questions concerning urine and stone analysis over a period of months, and then met to develop consensus. The Group concluded that analyses of urine and stones should be routine in the diagnosis and treatment of urinary stone diseases. At present, the 24-h urine is the most useful type of urine collection, and accepted methods for analysis are described. Patient education is also important for obtaining a proper urine sample. Graphical methods for reporting urine analysis results can be helpful both for the physician and for educating the patient as to proper dietary changes that could be beneficial. Proper analysis of stones is also essential for diagnosis and management of patients. The Consensus Group also agreed that research has shown that evaluation of urinary crystals could be very valuable, but the Group also recognizes that existing methods for assessment of crystalluria do not allow this to be part of stone treatment in many places.

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Section: Q2 What Type Of Urine Collection Is Best For Assessing a Pamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Urine and stone analysis for the investigation of the renal stone former: a consensus conference

et al. 2020

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“…Most kidney calculi are composed of calcium; calcium oxalate stones are the most common, accounting for 74.8% of all cases of stones [3]. In response to increasing incidence of kidney calculi, various interventions have been performed to prevent the occurrence of stones, including dietary interventions and medical treatments [4][5][6]. Among them, thiazide diuretics are the commonly used drugs for preventing recurrent kidney calculi [7,8].…”

Section: Page 2 Of 12mentioning

confidence: 99%

Use of thiazide diuretics for the prevention of recurrent kidney calculi: a systematic review and meta-analysis

Gao

Liu

et al. 2020

J Transl Med

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Background: Thiazide diuretics reduce the risk of recurrent kidney calculi in patients with kidney calculi or hypercalciuria. However, whether thiazide diuretics can definitely prevent recurrent kidney calculi remains unclear. We aimed to evaluate the effect and safety of thiazide diuretics on recurrent kidney calculi. Methods:The PubMed, Cochrane Library, and EMBASE databases were systematically searched using the keywords thiazide diuretics and kidney calculi to identify randomized controlled trials (RCTs). The primary outcome was the incidence of recurrent kidney calculi, and the secondary outcome was the 24-h urinary calcium level. The pooled risk ratio (RR), risk difference (RD), standardized mean difference (SMD), and 95% confidence interval (CI) were calculated. The evidence quality was graded using the GRADE criteria, and recommendations for recurrent kidney calculus prevention using thiazide diuretics were reassessed.Results: Eight RCTs involving 571 patients were included. The pooled RR for the incidence of kidney calculi in the thiazide diuretic groups was 0.44 (95% CI 0.33-0.58, P < 0.0001) compared to that in the placebo and untreated groups; the pooled RD was − 0.23 (95% CI − 0.30 to − 0.16, P < 0.0001). The pooled SMD for the 24-h urinary calcium level was − 18.59 (95% CI − 25.11 to − 12.08, P < 0.0001). The thiazide diuretic groups had a high incidence of adverse reactions and low tolerance. The evidence quality for decrease in kidney calculus incidence using thiazide diuretics was low, while that for the 24-h urinary calcium level decrease among those with recurrent kidney calculi was moderate, and that for the decrease in kidney calculus incidence using short-acting and long-acting thiazide diuretics was low. The overall strength of recommendation for prevention of recurrent renal calculi using thiazide diuretics was not recommended. The subgroup and sensitivity analysis findings were robust. Conclusions:Long-term use of thiazide diuretics reduces the incidence of recurrent renal calculi and 24-h urinary calcium level. However, the benefits are insufficient, and the evidence quality is low. Considering the adverse effects, poor patient compliance, and economic burden of long-term medication, their use in preventing recurrent kidney calculi is not recommended.

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“…Существуют и другие подобные сообщения, поддерживающие нашу гипотезу; к тому же широко известно, что кюретаж полости слезных канальцев при каналикулите является высокоэффективным вмешательством, а рецидивы после него редки [8][9][10]. В настоящее время уже разработаны консервативные способы лечения пациентов с мочекаменной болезнью, которые показали свою высокую эффективность, однако разработка таких методик потребовала наличия мощной фундаментальной и клинической научной базы, включая генетические, химико-аналитические и физико-механические исследования [11].…”

Section: обзоры литературы Literature Reviewsunclassified

Formation of concrements in the lacrimal excretory system

Yartsev¹,

Kova²

2020

Vestn. oftal'mol.

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Изучение патогенеза конкрементообразования в слезоотводящих путях имеет фундаментальное и практическое значение. В настоящей работе предпринята попытка проанализировать доступные сведения, имеющие отношение к вопросу патогенеза этого явления. В статье отдельно приводятся сведения об этиопатогенезе, физических и химических свойствах конкрементов, полученных из горизонтальной и вертикальной части слезоотводящих путей, подробно анализирован бактериологи ческий и микотический состав конкрементов, приведены различные теории конкрементообразования. Анализ позволил обосновать необходимость разделения конкрементов, образующихся в горизонтальной и вертикальной час ти слезоотводящих путей на основании различий в патогенезе. Этиология конкрементообразования в горизонтальной части слезоотводящих путей в подавляющем большинстве случаев состоит в актиномикотической инфекции. Процесс конкрементообразования в вертикальной части слезоотводящих путей в ряде случаев происходит вследствие предшествующих клинических событий, в других случаях триггерные механизмы остаются неизвестными. На сегодняшний день роль первичного сужения слезоотводящих путей в патогенезе конкрементообразования однозначно не определена. Накопленные знания относительно патогенеза конкрементообразования к настоящему моменту не позволяют сформулировать полную теорию развития этого явления. Дальнейшие исследования патогенеза конкрементообразования актуальны, так как позволят разработать новые диагностические и терапевтические мероприятия, направленные на восстановление проходимости слезоотводящих путей.

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Empiric therapy for kidney stones

Cited by 35 publications

References 61 publications

Urine and stone analysis for the investigation of the renal stone former: a consensus conference

Urine and stone analysis for the investigation of the renal stone former: a consensus conference

Use of thiazide diuretics for the prevention of recurrent kidney calculi: a systematic review and meta-analysis

Formation of concrements in the lacrimal excretory system

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