Medications help passage of kidney stones
Do medications help the passage of kidney stones?
The limited amount of available data suggest that alpha blockers and calcium channel blockers appear to speed the passage of kidney stones. Furthermore, it appears that combining these medications with steroids provides additional benefit. (LOE = 1a-)
Hollingsworth JM, Rogers MA, Kaufman SR, et al. Medical therapy to facilitate urinary stone passage: a meta-analysis. Lancet 2006;368:1171-1179. [PMID:17011944]
Meta-analysis (randomized controlled trials)
These authors searched multiple databases looking for randomized controlled trials of the effect of calcium channel blockers and alpha blockers on the passage of kidney stones. They also searched for unpublished studies. Two authors independently reviewed each study, assessed their quality, and extracted the data. Discrepancies were reconciled by consensus. The authors included 9 trials with a total of 693 patients in this study. Unfortunately, the authors don't report the doses of the drugs used in the included studies. In the 6 studies reporting time to stone passage, the range was as short as 6 days in several treatment groups to as long as 20 days in a control group. In 5 of those 6 trials, the treatment group had a shorter time to stone passage. The authors report that patients receiving active treatment had a 65% relative increased rate of stone passage compared with control patients. Based on the authors' estimates, we would need to treat 4 patients to facilitate the passage of 1 stone. A few studies also used steroids and the results suggest an additional benefit. Finally, the researchers report that most of the variability among the studies was attributable to variable inclusion criteria. Although they found no statistical evidence of publication bias, the authors are cautious about its potential.
Barry, Henry, et al., editors. "Medications Help Passage of Kidney Stones." EE+ POEM Archive, John Wiley & Sons, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426028/all/Medications_help_passage_of_kidney_stones.
Medications help passage of kidney stones. In: Barry HH, Ebell MHM, Shaughnessy AFA, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2019. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426028/all/Medications_help_passage_of_kidney_stones. Accessed December 10, 2023.
Medications help passage of kidney stones. (2019). In Barry, H., Ebell, M. H., Shaughnessy, A. F., & Slawson, D. C. (Eds.), EE+ POEM Archive. John Wiley & Sons. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426028/all/Medications_help_passage_of_kidney_stones
Medications Help Passage of Kidney Stones [Internet]. In: Barry HH, Ebell MHM, Shaughnessy AFA, Slawson DCD, editors. EE+ POEM Archive. John Wiley & Sons; 2019. [cited 2023 December 10]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426028/all/Medications_help_passage_of_kidney_stones.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Medications help passage of kidney stones ID - 426028 ED - Barry,Henry, ED - Ebell,Mark H, ED - Shaughnessy,Allen F, ED - Slawson,David C, BT - EE+ POEM Archive UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426028/all/Medications_help_passage_of_kidney_stones PB - John Wiley & Sons DB - Evidence Central DP - Unbound Medicine ER -