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[Change in the prevention of kidney stones]

Cyril Derouet1, Sébastien Kissling1, Beat Roth2

  • 1Service de néphrologie, Centre hospitalier universitaire vaudois, 1011 Lausanne.

Revue Medicale Suisse
|February 28, 2024
PubMed

Insights

Preventing kidney stones after passing a calcium-containing stone may not benefit from hydrochlorothiazide. Careful risk-benefit assessment is needed for thiazide prescriptions in kidney stone prevention.

Area of Science:

  • Nephrology
  • Urology
  • Pharmacology

Context:

  • Kidney stones are common urinary tract disorders.
  • Post-passage management focuses on prevention.
  • Lifestyle and dietary changes are key components of patient education.

Purpose:

  • To evaluate the efficacy of hydrochlorothiazide in preventing kidney stone recurrence.
  • To challenge the routine prescription of drugs for kidney stone prevention.

Summary:

  • The NOSTONE trial, a randomized controlled trial, investigated hydrochlorothiazide's role in preventing kidney stone recurrence in patients with calcium-containing stones.
  • The trial found no significant benefit of hydrochlorothiazide in reducing kidney stone recurrence.
  • This suggests thiazide prescription solely for prevention should be limited.

Impact:

  • Clinical practice guidelines for kidney stone prevention may need revision.
  • Physicians should carefully weigh the risks and benefits of thiazide therapy for individual patients.
  • Further research may explore alternative or adjunct therapies for kidney stone prevention.

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