Tseng TY et al, 2011: Kidney stones
Tseng TY, Preminger GM
University of Texas Health Science Center, San Antonio, TX, USA
INTRODUCTION: The age of peak incidence for stone disease is 20 to 40 years, although stones are seen in all age groups. There is a male to female ratio of 3:2.
METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions for stone removal in people with asymptomatic kidney stones? What are the effects of interventions for the removal of symptomatic renal stones? What are the effects of interventions to remove symptomatic ureteric stones? What are the effects of interventions for the management of acute renal colic? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS: We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: antispasmodic drugs, extracorporeal shockwave lithotripsy, intravenous fluids, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, oral fluids, percutaneous nephrolithotomy, and ureteroscopy.
Clin Evid (Online). 2011 Nov 10;2011. pii: 2003
PMID:22075544[PubMed - in process]
This text is an extensive and systematic review of studies on methods for active removal of symptomatic and asymptomatic renal and ureteral stones. Evidence on the effects of various forms of conservative treatment also was analysed, from available randomized control studies. The role of ESWL is compared with other stone removing procedures including open surgery.
Recorded side effects are shown. The article is of interest particularly as a summarizing source of randomized control studies so far published.