The use of alpha-adrenergic antagonists in pediatric nephrolithiasis: a systematic review.

IF 2.1 3区 医学 Q2 PEDIATRICS Frontiers in Pediatrics Pub Date : 2024-12-02 eCollection Date: 2024-01-01 DOI:10.3389/fped.2024.1396659
Firas Haddad, Walid A Farhat, Shannon Cannon
{"title":"The use of alpha-adrenergic antagonists in pediatric nephrolithiasis: a systematic review.","authors":"Firas Haddad, Walid A Farhat, Shannon Cannon","doi":"10.3389/fped.2024.1396659","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate existing clinical evidence for the efficacy of alpha blockers in the management of pediatric stone disease.</p><p><strong>Methods: </strong>We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort and randomized control trials of patients less than 18 years old with kidney stones managed with alpha-adrenergic antagonists were included. Outcomes included stone expulsion time, stone passage rate, mean number of pain episodes, and mean need for analgesics. We performed data extraction of the selected articles, and results were assimilated and synthesized qualitatively. Data extraction and risk of bias assessment was conducted by two independent reviewers.</p><p><strong>Results: </strong>Of 257 relevant studies, 9 studies with 1,039 patients were included. Six studies measured stone expulsion time, with 5 studies noting statistically significant decreases in stone expulsion time for the treatment group compared to the control. Seven studies measured the stone expulsion rate, and 5 reported a statistically significant increased expulsion rate in the treatment group. Four studies reported a decrease in the mean number of pain episodes in the treatment group and two studies showed a decreased analgesic requirement compared to control. Two studies found alpha blockers not superior to watchful waiting after shock wave lithotripsy. Risk of bias was high in some studies, primarily due to incomplete reporting on methodology and study design.</p><p><strong>Conclusions: </strong>Alpha blockers are supported by a growing body of evidence to be effective against nephrolithiasis in children, however large-scale, well-designed studies are needed to confirm these findings.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=330068, PROSPERO (CRD42022330068).</p>","PeriodicalId":12637,"journal":{"name":"Frontiers in Pediatrics","volume":"12 ","pages":"1396659"},"PeriodicalIF":2.1000,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646727/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fped.2024.1396659","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To evaluate existing clinical evidence for the efficacy of alpha blockers in the management of pediatric stone disease.

Methods: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort and randomized control trials of patients less than 18 years old with kidney stones managed with alpha-adrenergic antagonists were included. Outcomes included stone expulsion time, stone passage rate, mean number of pain episodes, and mean need for analgesics. We performed data extraction of the selected articles, and results were assimilated and synthesized qualitatively. Data extraction and risk of bias assessment was conducted by two independent reviewers.

Results: Of 257 relevant studies, 9 studies with 1,039 patients were included. Six studies measured stone expulsion time, with 5 studies noting statistically significant decreases in stone expulsion time for the treatment group compared to the control. Seven studies measured the stone expulsion rate, and 5 reported a statistically significant increased expulsion rate in the treatment group. Four studies reported a decrease in the mean number of pain episodes in the treatment group and two studies showed a decreased analgesic requirement compared to control. Two studies found alpha blockers not superior to watchful waiting after shock wave lithotripsy. Risk of bias was high in some studies, primarily due to incomplete reporting on methodology and study design.

Conclusions: Alpha blockers are supported by a growing body of evidence to be effective against nephrolithiasis in children, however large-scale, well-designed studies are needed to confirm these findings.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=330068, PROSPERO (CRD42022330068).

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
目的:评估α受体阻滞剂治疗小儿结石病疗效的现有临床证据:评估α受体阻滞剂治疗小儿结石病疗效的现有临床证据:我们按照系统综述和荟萃分析首选报告项目(PRISMA)指南进行了系统综述。研究对象包括使用α-肾上腺素能拮抗剂治疗 18 岁以下肾结石患者的队列试验和随机对照试验。研究结果包括结石排出时间、结石通过率、疼痛发作的平均次数以及镇痛剂的平均需求量。我们对所选文章进行了数据提取,并对结果进行了同化和定性综合。数据提取和偏倚风险评估由两名独立审稿人完成:在 257 项相关研究中,共纳入了 9 项研究,涉及 1,039 名患者。六项研究测量了排石时间,其中五项研究指出,与对照组相比,治疗组的排石时间在统计学上显著缩短。7 项研究测量了结石排出率,其中 5 项研究报告称治疗组的结石排出率在统计学上有显著提高。四项研究报告称,与对照组相比,治疗组的平均疼痛发作次数减少,两项研究显示镇痛剂需求量减少。两项研究发现,冲击波碎石术后使用α受体阻滞剂并不优于观察等待。一些研究的偏倚风险较高,主要是由于方法学和研究设计方面的报告不完整:越来越多的证据表明,α受体阻滞剂对儿童肾炎有效,但还需要大规模、设计良好的研究来证实这些发现。系统综述注册:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=330068,PROSPERO (CRD42022330068)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Frontiers in Pediatrics
Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
3.60
自引率
7.70%
发文量
2132
审稿时长
14 weeks
期刊介绍: Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
期刊最新文献
Bacteriological diagnosis of osteoarticular infections caused by Kingella kingae; a narrative review. The safety of cyclosporine and tacrolimus in pediatric nephrotic syndrome patients: a disproportionate analysis based on the FAERS database. Translation and cross-cultural validation of the Lithuanian version of the sleep-related breathing disorder scale of the Pediatric Sleep Questionnaire. Cerebral tissue oxygen saturation and its potential relationship with neurodevelopmental delay in pediatric liver transplant recipients. Changes in blood glucose and lipid metabolism levels in children with central precocious puberty and its correlation with obesity.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1