Preventing and treating kidney stones: an umbrella review of meta-analyses of non-surgical randomized controlled trials

source extracted confidence: high 2026-04-09
#humans #kidney-calculi #lithotripsy #meta-analysis-as-topic #randomized-controlled-trials-as-topic

Preventing and treating kidney stones: an umbrella review of meta-analyses of non-surgical randomized controlled trials

Veronese et al., 2025 | Minerva Urol Nephrol | Systematic Review

Citation

Veronese Nicola, Ciriminna Stefano, ... Pavan Nicola. Preventing and treating kidney stones: an umbrella review of meta-analyses of non-surgical randomized controlled trials. Minerva Urol Nephrol. 2025-Aug;77(4):472-478. doi:10.23736/S2724-6051.25.06296-2

Abstract

INTRODUCTION: Kidney stones represent a significant health burden due to their high prevalence, recurrence, and associated healthcare costs. Medical interventions are crucial for preventing and treating kidney stones, especially for patients at high risk or those undergoing extracorporeal shock wave lithotripsy (SWL). This umbrella review aims to synthesize evidence from systematic reviews and meta-analyses of randomized controlled trials (RCTs) evaluating the efficacy of non-surgical medical treatments in preventing and managing kidney stones. EVIDENCE ACQUISITION: A comprehensive search was conducted across Medline, Embase, and Web of Science until February 2024. Systematic reviews with meta-analyses of RCTs focusing on non-surgical medical interventions for kidney stone prevention and treatment were included. The GRADE framework evaluated the certainty of evidence. EVIDENCE SYNTHESIS: Among 2481 records initially considered, nine systematic reviews comprising 88 RCTs and 27,286 participants were included. Supported by a high level of evidence according to the GRADE, tamsulosin, compared to placebo, demonstrated improved stone clearance post-SWL, while vitamin D and calcium supplementation were ineffective for primary prevention. In 571 patients affected by recurrent kidney calculi, the use of thiazides, compared to placebo, was associated with a statistically significant decrease in renal stones of 66% (GRADE: high level of evidence). The use of potassium citrate was able to prevent the risk of nephrolithiasis recurrence of 79%, supported by a high level of evidence. CONCLUSIONS: Several medical interventions for kidney stone management are supported by high-certainty evidence, particularly post-SWL α-blocker therapy and potassium citrate for recurrence prevention.

Key Findings

Several medical interventions for kidney stone management are supported by high-certainty evidence, particularly post-SWL α-blocker therapy and potassium citrate for recurrence prevention.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 27286
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Kidney Calculi
  • Lithotripsy
  • Meta-Analysis as Topic
  • Randomized Controlled Trials as Topic
  • Systematic Reviews as Topic

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: potassium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09