Use of thiazide diuretics for the prevention of recurrent kidney calculi: a systematic review and meta-analysis

Autor:	Xiao-chen Huang, Dan-Feng Li, Changtai Zhu, Yu-lu Gao, Hong-Chao Liu, Rui-fang Zhu
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Thiazide diuretics medicine.medical_specialty Sodium Chloride Symporter Inhibitors Hypercalciuria 030232 urology & nephrology Urology lcsh:Medicine Review urologic and male genital diseases General Biochemistry Genetics and Molecular Biology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine Humans 030212 general & internal medicine Adverse effect Diuretics Thiazide Placebo business.industry Incidence (epidemiology) lcsh:R General Medicine medicine.disease Urinary calcium Meta-analysis Relative risk Kidney calculi business medicine.drug
Zdroj:	Journal of Translational Medicine, Vol 18, Iss 1, Pp 1-12 (2020) Journal of Translational Medicine
ISSN:	1479-5876
DOI:	10.1186/s12967-020-02270-7
Popis:	Background Thiazide diuretics reduce the risk of recurrent kidney calculi in patients with kidney calculi or hypercalciuria. However, whether thiazide diuretics can definitely prevent recurrent kidney calculi remains unclear. We aimed to evaluate the effect and safety of thiazide diuretics on recurrent kidney calculi. Methods The PubMed, Cochrane Library, and EMBASE databases were systematically searched using the keywords thiazide diuretics and kidney calculi to identify randomized controlled trials (RCTs). The primary outcome was the incidence of recurrent kidney calculi, and the secondary outcome was the 24-h urinary calcium level. The pooled risk ratio (RR), risk difference (RD), standardized mean difference (SMD), and 95% confidence interval (CI) were calculated. The evidence quality was graded using the GRADE criteria, and recommendations for recurrent kidney calculus prevention using thiazide diuretics were reassessed. Results Eight RCTs involving 571 patients were included. The pooled RR for the incidence of kidney calculi in the thiazide diuretic groups was 0.44 (95% CI 0.33–0.58, P P P Conclusions Long-term use of thiazide diuretics reduces the incidence of recurrent renal calculi and 24-h urinary calcium level. However, the benefits are insufficient, and the evidence quality is low. Considering the adverse effects, poor patient compliance, and economic burden of long-term medication, their use in preventing recurrent kidney calculi is not recommended.
Databáze:	OpenAIRE
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