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The role of corticosteroids in the management of kidney stones disease: a systematic review

Ahmed Nouri*, Mohamed Azmi Hassali & Azhar Amir Hamza

Background: Therapy for kidney stones disease has undergone many changes in the last decades. Medical expulsive therapy such as alpha-blockers and calcium channel blockers regarded as effective agents for stones expulsion and colic pain alleviation. However, many studies have used corticosteroids to utilize their actions in urolithiasis management as well.

Objectives: To determine the role of corticosteroids in the management of urolithiasis in terms of stone expulsion rate and stones expulsion time.

Methods: Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, a literature search using electronic databases including Pub Med, Google Scholar, and Science Direct was undertaken. Full text, prospective, English published studies were included.

Results: Initial search identified 1261 studies. By excluding duplicates, irrelevant titles, and articles that don’t fulfil the inclusion criteria, six articles were included. The included studies were conducted in three countries that was published between 2000 and 2016. All studies examined patients with ureteral stones. The corticosteroids used were (deflazacort, methylprednisolone, and prednisolone); each trial used one of them as monotherapy or in combination with another medical expulsive therapy agent. The retrieved studies achieved their objectives by investigating stone expulsion rates and stone expulsion time mainly.

Conclusions: Corticosteroids can improve the action of medical expulsive drugs when combined with nifedipine or alfa-antagonists for the treatment of ureterolithiasis. In which, reduction of the time for stone passage was statistically significant in most studies while corticosteroids monotherapy was not effective by any means. However, future prospective research studies are required to determine the corticosteroids actual role in the management of urinary tract stones and the worthiness of its combination.