Water for preventing urinary calculi

 

Abstract

Background

Urinary calculi is a common condition characterized of high incidence and high recurrence rate. For a long time, increased water intake has been the main preventive measure for the disease and its recurrence.

Objectives

To access the effectiveness of increased water intake for the primary and secondary prevention of urinary calculi.

Search methods

Relevant RCTs were identified by electronic and documental searches of MEDLINE, EMBASE, the Chinese Biomedical Disk and the Cochrane Central Register of Controlled Trials. No language restriction was applied.
Date of last search: November 2005.

Selection criteria

Randomised controlled trials (RCTs) and quasi-RCTs of increased water intake for the prevention of urinary calculi and its recurrence.

Data collection and analysis

Two reviewers independently assessed trial quality and extracted data. Statistical analyses were performed using the random effects model and the results expressed as risk ratio (RR) for dichotomous outcomes or mean difference (MD) for continuous data with 95% confidence intervals (CI).

Main results

No trials of increased water intake for the primary prevention of urinary calculi met the inclusion criteria. One trial with 199 patients provided results of increased water intake for the recurrence of urinary calculi. The recurrence rate was lower in the increased water intake group than that of the no intervention group (12% versus 27%, P = 0.008, RR = 0.45, 95% CI 0.24 to 0.84). The average interval for recurrences was 3.23 ± 1.1 years in increased water intake group and 2.09 ± 1.37 years in the no intervention group (P = 0.016, MD = 1.14, 95% CI 0.33 to 1.95).

Authors' conclusions

The evidence from only one trial indicates that increased water intake reduces the risk of recurrence of urinary calculi and prolongs the average interval for recurrences. However further research is required. Due to the lack of appropriate RCTs, no conclusions can be drawn on increased water intake for the primary and secondary prevention of urinary calculi.

 

Plain language summary

Increased water intake may help reduce the risk of recurrence of kidney stones but more studies are needed

Kidney stones (also known as calculi) are masses of crystals and protein and are common causes of urinary tract obstruction in adults. For a long time, increased water intake has been the main preventive measure for the disease and its recurrence. In this review only one trial was found that looked at the effect of increase water intake on recurrence and time to recurrence. Increased water intake decreased the chance of recurrence and increased the time to recurrence. Further studies are needed.

 

摘要

背景

水分攝取和預防尿路結石

尿路結石是一種有高盛行率和高復發率的常見情況。長期以來，增加水分攝取在這個情況下都被當成一種預防此疾病和再發的方法。

目標

評估增加水分攝取在尿路結石的初段預防和次段預防之成效

搜尋策略

使用MEDLINE, EMBASE, the Chinese Biomedical Disk and the Cochrane Central Register of Controlled Trials資料庫的電子或紙本期刊，尋找出相關的隨機對照試驗，不受語言的限制。最後一次搜尋日期: 2005年11月

選擇標準

涵括提及增加水分攝取能預防尿路結石及再發的所有隨機對照試驗或準隨機對照試驗

資料收集與分析

二位研究者獨立分析試驗的品質和蒐集的資料。統計分析用隨機效果模式，結果則用相對風險 (RR) 表示二元結果或以加權平均差併用百分之九十五的信賴區間 (CI) 的方式表示連續性資料

主要結論

在初段預防尿路結石方面，沒有任何增加水分攝取的試驗符合入選條件。 有一個包含了199位病人的試驗提到，增加水分攝取尿路結石再發率比沒有任何處置者低 (百分之十二比百分之二十七, P值 = 0.0008, 相對風險 = 0.45, 百分之九十五信賴區間 0.24到 0.84) 。增加水分攝取的族群平均再發時間是3.23 1.1 年，沒有任何處置的族群約 2.09 1.37年 (P值 = 0.016，加權平均差 = 1.14, 百分之九十五信賴區間介於 0.33 到1.95之間)

作者結論

只有一篇試驗的證據提到增加水分攝取可以減少尿路結石再發而延長平均再發時間。然而需要更進一步的研究。因為缺乏合適的隨機對照試驗，增加水分攝取在尿路結石的初段預防和次段預防上仍沒有結論

翻譯人

本摘要由馬偕醫院郭馨仁翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

增加水分攝取也許可以減少尿路結石的再發，但需要更多研究。腎結石是晶體和蛋白質的組成，在成人常見造成尿路阻塞。長期以來，增加水分攝取是預防此疾病的主要方法。在這篇綜論只發現一個試驗在探討增加水分攝取對於結石再發及再發時間的影響，發現增加水分攝取可以減少尿路結石的再發的機會及延長再發時間。此議題仍須要更進一步的研究