POEMs

Kidney Stones: Prevention Options



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Am Fam Physician. 2013 Nov 1;88(9):609-610.

Clinical Question

What is the best approach to prevent recurrent kidney stones?

Bottom Line

Increased fluid intake or decreased soft drink intake may prevent further kidney stones in patients with a single episode of a calcium stone, but other dietary interventions are not effective. Thiazides and citrates with increased fluid intake decrease recurrence in patients with multiple past stones, as does allopurinol (Zyloprim) in patients with high uric acid levels. Combinations—allopurinol and citrates with a thiazide—are no more effective than thiazides alone. (Level of Evidence = 1a)

Synopsis

The researchers conducting this systematic review searched several databases, including the Cochrane library, and identified 28 English-language randomized trials that compared approaches

POEMs (patient-oriented evidence that matters) are provided by Essential Evidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.


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