SynthesisWorld journal of urology2025
Thiazide and thiazide-like diuretics for kidney stones recurrence: a systematic review and network meta-analysis of randomised controlled trials.
Synthesis in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Identification of key molecules and pathways in CaOx crystal-induced renal injury based on metabolomics and proteomics.International urology and nephrology · 2026Article
- Citrate-coated Prussian blue nanozyme hitchhikes neutrophils to ameliorate calcium oxalate crystal-induced kidney injury via inhibiting pyroptosis and NETosis.Journal of nanobiotechnology · 2026Article
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Authors and funding
5 authors.
Funding
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Abstract
purposeThiazide (THZ) and thiazide-like (TL) diuretics are routinely prescribed and considered to be the gold-standard prophylaxis for kidney stones (KS) recurrence in current guidelines despite having limited evidence. Thus, we aimed to investigate the efficacy and safety of different doses of THZ and TL diuretics in preventing KS recurrence.
methodsWe searched for randomised controlled trials in PubMed, Web of Science, Embase, CENTRAL, and clinical trials registries from their inception through January 2025. The clinical or radiological KS recurrence was the primary endpoint, while the occurrence of adverse effects at any time was the secondary endpoint. We estimated odds ratio (OR) in a frequentist random-effects network meta-analysis with P < 0.05. This study was prospectively registered (CRD42025650062).
resultsNine trials (n = 999) were included. Chlorthalidone 50 mg/d (OR: 0.18, 95% confidence interval [CI] 0.04-0.88), hydrochlorothiazide 50 mg/d (OR: 0.52, CI 0.29-0.93), and trichlormethiazide 4 mg/d (OR: 0.26, CI 0.10-0.68) were different from placebo in terms of KS recurrence. There was no evidence of dose-dependent effect when comparing hydrochlorothiazide 50 mg/d to 12.5 mg/d (OR: 0.58, CI 0.25-1.34) or 25 mg/d (OR: 0.65, CI 0.28-1.48), nor comparing chlorthalidone 50 mg/d to 25 mg/d (OR: 0.80, CI 0.12-5.20). Only trichlormethiazide 4 mg/d (OR: 49.96, CI 1.78-1 402.80) provoked more adverse effects than placebo.
conclusionAlthough some therapies were statistically different from placebo, the current evidence does not support their use in preventing KS recurrence due to several limitations, indicating that THZ and/or TL diuretics should not be routinely prescribed. Further well-designed trials are urgently needed to address head-to-head comparisons and provide high-quality evidence.
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