Lo Christopher Y Z, Khor Qian Hui, Abdullatif Victor A, Delgado Cesar, Lu Yadong, Katz Jonathan, Sur Roger L
Duke-NUS Medical School, Singapore, Singapore.
Changi General Hospital, Singapore, Singapore.
Asian J Urol. 2025 Apr;12(2):169-188. doi: 10.1016/j.ajur.2024.04.006. Epub 2024 Jul 4.
Several therapeutic modalities for the prevention of calcium oxalate (CaOx) stones have been studied, but only a select few of these modalities have been incorporated into the American Urological Association guidelines. Our study aimed to organize and interrogate existing research that may be promising for CaOx prevention.
A literature search was conducted using MEDLINE and Embase from inception to November 16, 2022. Our study population included adults with or without a history of CaOx kidney stones. Studies in which patients were treated with pharmacotherapies, herbal supplements, or uncategorized research chemicals that are not included in the current American Urological Association guidelines for preventing CaOx stones were included. Nonoriginal research was excluded.
Out of the 6155 identified articles, 38 were included in the final analysis. The five distinct categories of interventions for stone prevention were "medications", "herbal supplements", "food and macronutrients", "micronutrients", and "enzymes and probiotics". Modalities that were found to reduce known urinary risk factors were tolvaptan, cranberry juice, magnesium citrate, oxalate-degrading enzyme ALLN-177, and malic acid. Prophylaxis that reduced stone formation were sodium-glucose cotransporter-2 inhibitors, eicosapentaenoic acid, ethane-1-hydroxy-1,1-disphosphonate. Therapies that reduced urinary risk factors and stone formation were , rice bran, and magnesium hydroxide.
Several of the identified therapies may provide prophylactic benefits for CaOx stone formation and may be useful for inclusion in guidelines for kidney stone prevention.
已经对几种预防草酸钙（CaOx）结石的治疗方法进行了研究，但只有少数几种方法被纳入美国泌尿外科学会指南。我们的研究旨在整理和审视可能对预防CaOx有前景的现有研究。
使用MEDLINE和Embase从创刊到2022年11月16日进行文献检索。我们的研究人群包括有或无CaOx肾结石病史的成年人。纳入了对患者使用药物治疗、草药补充剂或当前美国泌尿外科学会预防CaOx结石指南未涵盖的未分类研究化学品进行治疗的研究。排除非原创研究。
在6155篇检索到的文章中，38篇被纳入最终分析。预防结石的五种不同干预类别为“药物”“草药补充剂”“食物和常量营养素”“微量营养素”以及“酶和益生菌”。被发现可降低已知尿液危险因素的方法有托伐普坦、蔓越莓汁、柠檬酸镁、草酸降解酶ALLN - 177和苹果酸。减少结石形成的预防措施有钠 - 葡萄糖协同转运蛋白2抑制剂、二十碳五烯酸、乙烷 - 1 - 羟基 - 1,1 - 二膦酸盐。既降低尿液危险因素又减少结石形成的疗法有米糠和氢氧化镁。
一些已确定的疗法可能对CaOx结石形成具有预防作用，可能有助于纳入肾结石预防指南。
