Study: Alpha Blockers Are Effective for Kidney Stone Treatment

Alpha blockers can help patients pass kidney stones, and patients with larger kidney stones may see the most benefit, according to a new analysis.

The analysis aimed to better identify patients who are likely to benefit from alpha blockers.
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The researchers searched online databases for randomized controlled trials that compared alpha blockers with placebo or a control group in the treatment of ureteric stones. In all, 55 trials involving of 5990 study participants were included in the analysis.

The researchers noted patients who passed their stone, the time to passage, the number of pain episodes, and the number of patients who underwent surgery, required a hospital admission, and experienced an adverse event.

The GRADE approach was used to evaluate the quality of evidence and the Cochrane Collaboration’s tool was used to summarize conclusions.

Overall, analysis showed that alpha blockers increased the likelihood of stone passage. Patients with larger stones treated with an alpha blocker had the highest likelihood of stone passage (57%) compared with controls, whereas patients with smaller stones saw no effect. These results were consistent regardless of stone location or alpha blocker type.

In addition, alpha blockers were associated with significantly shorter times to stone passage (moderate-quality evidence), fewer pain episodes (low-quality evidence), lower risk of surgical intervention (moderate-quality evidence), and lower risk of hospital admission (moderate-quality evidence).

Serious adverse event rates were similar between the treatment and control groups.

“Alpha blockers seem efficacious in the treatment of patients with ureteric stones who are amenable to conservative management,” the researchers concluded. “The greatest benefit might be among those with larger stones. These results support current guideline recommendations advocating a role for alpha blockers in patients with ureteric stones.”

—Amanda Balbi

Reference:

Hollingsworth JM, Canales BK, Rogers MAM, et al. Alpha blockers for treatment of ureteric stones: systematic review and meta-analysis [published online December 1, 2016]. BMJ. http://dx.doi.org/10.1136/bmj.i6112.