CTU Bern

New study questions standard therapy for preventing kidney stones

06.03.2023 - Kidney stones are a common condition, about 10% of the population is affected. Diuretic drugs from the class of thiazide diuretics have been considered as the treatment of choice for the prevention of kidney stone recurrence for decades. A new study now published in the journal The New England Journal of Medicine calls this therapy into question.

The NOSTONE study is a randomized, multicenter, double-blind placebo-controlled trial investigating the efficacy and the dose-response effect of Hydrochlorothiazide on stone recurrence. A total of 416 patients with recurrent calcium-containing kidney stones were randomized to receive one of three doses of Hydrochlorothiazide: 12.5mg, 25mg, or 50mg once daily or placebo once daily for about three years. The primary outcome was the occurrence of kidney stone (symptomatic or radiological). There was no evidence of a relationship between the hydrochlorothiazide dose and the occurrence of a primary end-point event. As all hydrochlorothiazide groups (12.5-mg, 25-mg, and 50-mg) showed a similar incidence of recurrence as the placebo group, there was no evidence that Hydrochlorothiazide does perform better than placebo.

See for full details: https://www.nejm.org/doi/full/10.1056/NEJMoa2209275

CTU Bern was involved in the planning, data management, monitoring, project management and statistical analyses of the trial.