Pharmacological interventions for preventing complications in patients with idiopathic hypercalciuria: A systematic review
Objective: To assess the effects of pharmacological interventions in patients with idiopathic hypercalciuria. Methods: We performed a search of multiple databases, trial registries, grey literature and conference proceedings up to October 2019. We included randomized and quasi-randomized controlled...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | Spanish |
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Elsevier
2022-09-01
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| Series: | Nefrología |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0211699521001508 |
| _version_ | 1798003375679209472 |
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| author | Natalia Ferre Ester Parada Albert Balaguer Albert Feliu Marta Roqué-Figuls Juan Victor A. Franco Joaquín Escribano |
| author_facet | Natalia Ferre Ester Parada Albert Balaguer Albert Feliu Marta Roqué-Figuls Juan Victor A. Franco Joaquín Escribano |
| author_sort | Natalia Ferre |
| collection | DOAJ |
| description | Objective: To assess the effects of pharmacological interventions in patients with idiopathic hypercalciuria. Methods: We performed a search of multiple databases, trial registries, grey literature and conference proceedings up to October 2019. We included randomized and quasi-randomized controlled trials that examined any pharmacological intervention for preventing complications of idiopathic hypercalciuria (given for at least four months and six of follow-up). The primary outcomes were stone-free patients, urinary symptoms and severe adverse events. Results: We included five RCTs (n = 446 patients, all adults, 4 in individuals with kidney stones and 1 in postmenopausal women with osteoporosis). Diuretics were likely to increase the number of stone-free patients (RR 1.61, 95% CI 1.33–1.96, moderate quality of evidence (QoE)); 274 more stone-free patients/1000 patients treated (95% CI: 148–432) and produced a slight decrease in the stone formation rate (mean difference −0.18, 95% CI −0.30 to −0.06, low QoE); 180 fewer stones/year/1000 patients treated (95% CI: 300 r to 60). No data on urinary symptoms were reported. The association between diuretic use and severe adverse events was uncertain (RR 5.00, 95% CI 0.60–41.88, very low QoE); 4 more severe adverse events/1000 patients treated (95% CI: 0 fewer to 39 more). Conclusions: The addition of diuretics to a normal or modified diet probably reduces the number of stone recurrences and may decrease the stone formation rate. It is uncertain whether diuretics increase the occurrence of severe adverse events. There were no studies investigating other outcomes or in children. Resumen: Objetivo: Evaluar los efectos de intervenciones farmacológicas en pacientes con hipercalciuria idiopática. Métodos: Realizamos una búsqueda en múltiples bases de datos, registros de ensayos, literatura gris y actas de congresos hasta octubre de 2019. Incluimos ensayos clínicos aleatorizados y cuasialeatorizados que examinaban cualquier intervención farmacológica para prevenir las complicaciones de la hipercalciuria idiopática (mínimo 4 meses de intervención y 6 meses de seguimiento). Los outcomes primarios fueron pacientes libres de cálculos, síntomas urinarios y efectos adversos graves. Resultados: Incluimos 5 RCT (n = 446 pacientes, todos adultos, 4 en individuos con cálculos renales y uno en mujeres posmenopáusicas con osteoporosis). Los diuréticos aumentaban probablemente el número de pacientes libres de cálculos (RR 1,61; IC 95%: 1,33 a 1,96, moderada calidad de evidencia [QoE]); 274 más pacientes libres de cálculos/1.000 pacientes tratados (IC 95%: 148 a 432) y producían una ligera disminución en la tasa de formación de cálculos (diferencia media −0,18; IC 95%: −0,30 a −0,06, baja QoE); 180 menos cálculos/año/1.000 pacientes tratados (IC 95%: 300 a 60). No se informaron datos sobre síntomas urinarios. La asociación entre el uso de diuréticos y los efectos adversos graves fue incierta (RR 5,00; IC 95%: 0,60 a 41,88, muy baja QoE); 4 efectos adversos severos más/1.000 pacientes tratados (IC 95%: 0 a 39). Conclusiones: Los diuréticos añadidos a una dieta normal o modificada probablemente reducen la aparición de cálculos y pueden disminuir su tasa de formación. Es incierto si los diuréticos incrementan la ocurrencia de efectos adversos graves. No se encontraron estudios que investigaran otros outcomes o realizados en niños. |
| first_indexed | 2024-04-11T12:06:24Z |
| format | Article |
| id | doaj.art-af3262a111cb4349bd44c68a26e06b84 |
| institution | Directory Open Access Journal |
| issn | 0211-6995 |
| language | Spanish |
| last_indexed | 2024-04-11T12:06:24Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Nefrología |
| spelling | doaj.art-af3262a111cb4349bd44c68a26e06b842022-12-22T04:24:42ZspaElsevierNefrología0211-69952022-09-01425506518Pharmacological interventions for preventing complications in patients with idiopathic hypercalciuria: A systematic reviewNatalia Ferre0Ester Parada1Albert Balaguer2Albert Feliu3Marta Roqué-Figuls4Juan Victor A. Franco5Joaquín Escribano6Universitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, SpainUniversitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, Spain; Department of Pediatrics, Hospital Universitari de Tarragona Joan XXIII, Dr. Mallafré Guasch 4, 43005 Tarragona, SpainDepartment of Pediatrics, Hospital Universitari General de Catalunya, Pere i Pons 1, 08195 Sant Cugat del Vallés, Barcelona, Spain; Universitat Internacional de Catalunya, Carrer de la Immaculada 22, 08017 Barcelona, SpainUniversitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, Spain; Department of Pediatrics, Hospital Universitari St Joan de Reus, Avinguda del Doctor Josep Laporte 2, 43204 Reus, SpainIberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Sant Quintí 77-79, 08041 Barcelona, SpainArgentine Cochrane Centre, Instituto Universitario Hospital Italiano, Potosí 4265, C1199 CABA Buenos Aires, ArgentinaUniversitat Rovira i Virgili, School of Medicine, Pediatric Research Unit, Sant Llorenç 21, 43201 Reus, Spain; Department of Pediatrics, Hospital Universitari St Joan de Reus, Avinguda del Doctor Josep Laporte 2, 43204 Reus, Spain; Corresponding author.Objective: To assess the effects of pharmacological interventions in patients with idiopathic hypercalciuria. Methods: We performed a search of multiple databases, trial registries, grey literature and conference proceedings up to October 2019. We included randomized and quasi-randomized controlled trials that examined any pharmacological intervention for preventing complications of idiopathic hypercalciuria (given for at least four months and six of follow-up). The primary outcomes were stone-free patients, urinary symptoms and severe adverse events. Results: We included five RCTs (n = 446 patients, all adults, 4 in individuals with kidney stones and 1 in postmenopausal women with osteoporosis). Diuretics were likely to increase the number of stone-free patients (RR 1.61, 95% CI 1.33–1.96, moderate quality of evidence (QoE)); 274 more stone-free patients/1000 patients treated (95% CI: 148–432) and produced a slight decrease in the stone formation rate (mean difference −0.18, 95% CI −0.30 to −0.06, low QoE); 180 fewer stones/year/1000 patients treated (95% CI: 300 r to 60). No data on urinary symptoms were reported. The association between diuretic use and severe adverse events was uncertain (RR 5.00, 95% CI 0.60–41.88, very low QoE); 4 more severe adverse events/1000 patients treated (95% CI: 0 fewer to 39 more). Conclusions: The addition of diuretics to a normal or modified diet probably reduces the number of stone recurrences and may decrease the stone formation rate. It is uncertain whether diuretics increase the occurrence of severe adverse events. There were no studies investigating other outcomes or in children. Resumen: Objetivo: Evaluar los efectos de intervenciones farmacológicas en pacientes con hipercalciuria idiopática. Métodos: Realizamos una búsqueda en múltiples bases de datos, registros de ensayos, literatura gris y actas de congresos hasta octubre de 2019. Incluimos ensayos clínicos aleatorizados y cuasialeatorizados que examinaban cualquier intervención farmacológica para prevenir las complicaciones de la hipercalciuria idiopática (mínimo 4 meses de intervención y 6 meses de seguimiento). Los outcomes primarios fueron pacientes libres de cálculos, síntomas urinarios y efectos adversos graves. Resultados: Incluimos 5 RCT (n = 446 pacientes, todos adultos, 4 en individuos con cálculos renales y uno en mujeres posmenopáusicas con osteoporosis). Los diuréticos aumentaban probablemente el número de pacientes libres de cálculos (RR 1,61; IC 95%: 1,33 a 1,96, moderada calidad de evidencia [QoE]); 274 más pacientes libres de cálculos/1.000 pacientes tratados (IC 95%: 148 a 432) y producían una ligera disminución en la tasa de formación de cálculos (diferencia media −0,18; IC 95%: −0,30 a −0,06, baja QoE); 180 menos cálculos/año/1.000 pacientes tratados (IC 95%: 300 a 60). No se informaron datos sobre síntomas urinarios. La asociación entre el uso de diuréticos y los efectos adversos graves fue incierta (RR 5,00; IC 95%: 0,60 a 41,88, muy baja QoE); 4 efectos adversos severos más/1.000 pacientes tratados (IC 95%: 0 a 39). Conclusiones: Los diuréticos añadidos a una dieta normal o modificada probablemente reducen la aparición de cálculos y pueden disminuir su tasa de formación. Es incierto si los diuréticos incrementan la ocurrencia de efectos adversos graves. No se encontraron estudios que investigaran otros outcomes o realizados en niños.http://www.sciencedirect.com/science/article/pii/S0211699521001508Hipercaliuria idiopáticaDiuréticos, Cálculos renalesRevisión sistemática |
| spellingShingle | Natalia Ferre Ester Parada Albert Balaguer Albert Feliu Marta Roqué-Figuls Juan Victor A. Franco Joaquín Escribano Pharmacological interventions for preventing complications in patients with idiopathic hypercalciuria: A systematic review Nefrología Hipercaliuria idiopática Diuréticos, Cálculos renales Revisión sistemática |
| title | Pharmacological interventions for preventing complications in patients with idiopathic hypercalciuria: A systematic review |
| title_full | Pharmacological interventions for preventing complications in patients with idiopathic hypercalciuria: A systematic review |
| title_fullStr | Pharmacological interventions for preventing complications in patients with idiopathic hypercalciuria: A systematic review |
| title_full_unstemmed | Pharmacological interventions for preventing complications in patients with idiopathic hypercalciuria: A systematic review |
| title_short | Pharmacological interventions for preventing complications in patients with idiopathic hypercalciuria: A systematic review |
| title_sort | pharmacological interventions for preventing complications in patients with idiopathic hypercalciuria a systematic review |
| topic | Hipercaliuria idiopática Diuréticos, Cálculos renales Revisión sistemática |
| url | http://www.sciencedirect.com/science/article/pii/S0211699521001508 |
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