Therapy of nephrolithiasis: where is the evidence from clinical trials?

Area of Science:

• Nephrology
• Urology

Background:

• Kidney stone disease prevalence is increasing worldwide, posing significant health and economic challenges.
• Emerging research links kidney stones to serious morbidities, yet evidence on interventions to prevent recurrence is limited.

Purpose of the Study:

• To review current evidence on medical expulsive therapy for ureteral stones.
• To describe non-pharmacological therapies, including dietary modifications and citrus juice, for kidney stone management.
• To discuss the efficacy of thiazide diuretics in treating hypercalciuria for recurrent kidney stone prevention.

Main Methods:

• Systematic review of available evidence.
• Analysis of randomized clinical trials and observational studies.
• Evaluation of non-pharmacological interventions and pharmacological treatments.

Main Results:

• Evidence on medical expulsive therapy for ureteral stones was analyzed.
• Data on dietary modifications and citrus juice therapy were described.
• Efficacy of thiazide diuretics for hypercalciuria in recurrent nephrolithiasis was discussed.

Conclusions:

• Further high-quality studies are needed to establish effective interventions for decreasing kidney stone recurrence.
• Current evidence supports exploring various therapeutic avenues, including medical expulsive therapy, lifestyle changes, and diuretics.
• Understanding treatment efficacy is crucial for managing the growing burden of kidney stone disease.