Comparative Effectiveness

Increased fluid and supplemental treatments may reduce recurrence of kidney stones

Increased fluid intake, reduced soft drink consumption, thiazide diuretics (which lower urinary calcium excretion and prevent calcium-containing kidney stones), citrate pharmacotherapy (citrate naturally prevents kidney stone formation), and allopurinol (used to treat excess uric acid in blood plasma) each decreased the risk of recurrent calcium kidney stones, according to a new research review by the Agency for Healthcare Research and Quality's (AHRQ's) Effective Health Care Program. While research data on kidney stones remains limited, available research suggests that evidence is mixed on whether dietary intervention effectively reduces the risk of recurrent stones.

Kidney stones may be present at any age, but onset is more common in young and middle-aged adults. Lifetime prevalence is 13 percent for men and 7 percent for women. Following an initial onset of kidney stones, the 5-year recurrence rate in the absence of a specific treatment is between 35 to 50 percent. Direct medical expenditures related to kidney stones may exceed $4.5 billion annually in the United States. Nephrolithiasis is the clinical term for when hard masses form in the kidneys.

The new review, Recurrent Nephrolithiasis in Adults: A Comparative Effectiveness Review of Preventive Medical Strategies, summarizes available evidence on the effectiveness and risks of dietary and pharmacological preventive treatments. To access this review and other materials that explore the effectiveness and risks of treatment options for various conditions, visit AHRQ's Effective Health Care Program Web site at http://www.effectivehealthcare.ahrq.gov.

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