Related Experiment Video
Updated: Jun 4, 2025
Estimation of Urinary Nanocrystals in Humans using Calcium Fluorophore Labeling and Nanoparticle Tracking Analysis
Published on: February 9, 2021
The use of alpha-adrenergic antagonists in pediatric nephrolithiasis: a systematic review
Firas Haddad1, Walid A Farhat2, Shannon Cannon2
1Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Insights
Alpha blockers show promise in treating pediatric kidney stones by reducing expulsion time and increasing passage rates. Further high-quality research is needed to confirm their effectiveness in children.
Area of Science:
- Pediatric Nephrology
- Pharmacology
- Urology
Background:
- Kidney stone disease (nephrolithiasis) is a growing concern in pediatric populations.
- Management strategies for pediatric kidney stones often involve medical expulsive therapy.
- Alpha-adrenergic antagonists are increasingly explored for their role in managing pediatric urolithiasis.
Purpose of the Study:
- To systematically review and evaluate the existing clinical evidence on the efficacy of alpha blockers for pediatric stone disease.
- To synthesize findings regarding stone expulsion time, passage rates, pain episodes, and analgesic requirements.
Main Methods:
- A systematic review was conducted following PRISMA guidelines.
- Included were cohort and randomized control trials of patients under 18 with kidney stones treated with alpha-adrenergic antagonists.
- Data extraction and qualitative synthesis were performed, with two independent reviewers assessing risk of bias.
Main Results:
- Nine studies involving 1,039 pediatric patients were analyzed.
- A majority of studies indicated statistically significant reductions in stone expulsion time and increased stone passage rates with alpha blockers.
- Some studies reported decreased pain episodes and analgesic needs, though two found alpha blockers no better than watchful waiting post-lithotripsy.
Conclusions:
- Evidence suggests alpha blockers are effective in managing pediatric nephrolithiasis.
- High risk of bias was noted in some studies due to incomplete reporting.
- Larger, well-designed studies are required to definitively confirm the efficacy of alpha blockers in children.
Objective:
To evaluate existing clinical evidence for the efficacy of alpha blockers in the management of pediatric stone disease.
Methods:
We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort and randomized control trials of patients less than 18 years old with kidney stones managed with alpha-adrenergic antagonists were included. Outcomes included stone expulsion time, stone passage rate, mean number of pain episodes, and mean need for analgesics. We performed data extraction of the selected articles, and results were assimilated and synthesized qualitatively. Data extraction and risk of bias assessment was conducted by two independent reviewers.
Results:
Of 257 relevant studies, 9 studies with 1,039 patients were included. Six studies measured stone expulsion time, with 5 studies noting statistically significant decreases in stone expulsion time for the treatment group compared to the control. Seven studies measured the stone expulsion rate, and 5 reported a statistically significant increased expulsion rate in the treatment group. Four studies reported a decrease in the mean number of pain episodes in the treatment group and two studies showed a decreased analgesic requirement compared to control. Two studies found alpha blockers not superior to watchful waiting after shock wave lithotripsy. Risk of bias was high in some studies, primarily due to incomplete reporting on methodology and study design.
Conclusions:
Alpha blockers are supported by a growing body of evidence to be effective against nephrolithiasis in children, however large-scale, well-designed studies are needed to confirm these findings.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=330068, PROSPERO (CRD42022330068).
More Related Videos
03:19Author Spotlight: Developing a Bedside Protocol for Kidney and Genitourinary Ultrasonography
Published on: June 21, 2024
08:505/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
Published on: July 3, 2013
Related Concept Videos
01:22Adrenergic Antagonists: Pharmacological Actions of ɑ-Receptor Blockers
α1-blockers: These drugs inhibit α1-adrenoceptors on smooth muscle cells, resulting in vasodilation. This vasodilation lowers blood pressure, making α1-blockers valuable in treating hypertension. Additionally,...
01:30Adrenergic Agonists: Therapeutic Uses
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
01:17Adrenergic Antagonists: Chemistry and Classification of ɑ-Receptor Blockers
Nonselective α-blockers: Nonselective α-blockers contain haloalkylamine or imidazoline...
01:31Adrenergic Antagonists: ɑ and β-Receptor Blockers
01:27Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System