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Oral Zinc Sulfate as Adjuvant Treatment in Children With Nephrolithiasis: a Randomized, Double-Blind,
Parsa Yousefichaijan1, Ali Cyrus2, Fatemeh Dorreh3
1Department of Pediatric Nephrology, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran.
Insights
Oral zinc sulfate showed no significant therapeutic benefit beyond conservative treatment for pediatric nephrolithiasis. While stone size and number decreased in both groups, zinc did not offer a superior outcome in children with kidney stones.
Area of Science:
- Pediatric Nephrology
- Mineral Metabolism
- Urolithiasis Research
Background:
- Pediatric nephrolithiasis presents a high risk for complications and recurrence.
- Emerging evidence suggests zinc's role as a crystallization inhibitor.
- This study investigates zinc sulfate's efficacy in pediatric kidney stone management.
Purpose of the Study:
- To evaluate oral zinc sulfate as an adjuvant therapy for nephrolithiasis in children.
- To compare the effectiveness of zinc sulfate plus conservative measures against placebo plus conservative measures.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 102 children (1 month to 11 years) with first-time nephrolithiasis.
- Intervention group received 1 mg/kg/day oral zinc sulfate (max 20 mg/day) for 3 months.
- Control group received placebo for 3 months; both groups received conservative care and were followed for 9 months via ultrasonography.
Main Results:
- A statistically significant reduction in stone number and size was observed in the zinc group only at the 1-month follow-up (P = 0.001).
- No significant therapeutic efficacy of adjuvant zinc treatment was found at other time points compared to placebo.
- Both groups showed significant stone size and number reduction over 9 months, with no difference between groups.
Conclusions:
- Adjuvant oral zinc sulfate therapy is not more effective than conservative treatment alone for pediatric nephrolithiasis.
- Further clinical studies are recommended to explore zinc's role due to limited current evidence in this field.
Background:
Nephrolithiasis in children is associated with a high rate of complications and recurrence.
Objectives:
Since some evidences reported that zinc has an important place amongst inhibitors of crystallization and crystal growth, we decided to assess the effectiveness of oral zinc sulfate as adjuvant treatment in children with nephrolithiasis.
Patients And Methods:
This was a randomized, double-blind, placebo-controlled clinical trial. 102 children in the age range 1 month to 11 years with first nephrolithiasis were recruited. Patients were randomly divided into two equal groups (intervention and control groups). Intervention group received conservative measures for stones and 1 mg/kg/day (maximum 20 mg/day) oral zinc sulfate syrup for 3 months. Control group received placebo in addition to conservative measures, also for 3 months. Patients were followed up by ultrasonography for 9 months, in 5 steps (at the end of 1st, 2nd, 3rd, 6th and 9th month after treatment) assessing size and number of stones in the kidneys.
Results:
Only at the end of the first month, the average number (intervention: 1.15 ± 3.78, control: 1.3 ± 2.84) (P = 0.001) and size (cm) (intervention: 0.51 ± 1.76, control: 0.62 ± 1.39) (P = 0.001) of stones was significantly lower in the intervention group, and in other points there was no significant therapeutic efficacy in oral zinc adjuvant treatment compared to conservative treatment alone. Also, during the 9-month follow-up, the number and size of stones in both groups decreased significantly (both: P < 0.0001) in a way that the decrease in the intervention group showed no difference with the control group.
Conclusions:
Adjuvant treatment with zinc is not more effective than consecutive treatment in children with nephrolithiasis. However, further studies are recommended due to the lack of clinical evidence in this field.
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