Efficacy of Hydrochlorothiazide in Post Extra Corporeal Shock Wake Lithotripsy Stone-free time in Patients Referred to the ESWL Ward of Moradi Hospital of Rafsanjan

Extracorporeal shockwave lithotripsy (ESWL) is one of minimally invasive methods for the treatment of renal stones. Several factors affecting success rate of ESWL including; age, gender, weight, stone size, laterality and location of stone and materials stone. The aim of this study was to evaluate the effect of hydrochlorothiazide on the duration of renal pelvic stone passage after ESWL.

In this clinical trial approved by Iranian Registry of Clinical Trials (IRCT20171104037212N2), 199 patients with renal pelvis stone sized smaller than 20mm referred to the ESWL department of Moradi hospital in Rafsanjan during 2015-2016 were included. After ESWL process, patients were randomly divided into two groups; experimental and control groups. The experimental group received 25 mg hydrochlorothiazide tablets every 12 hours for 2 weeks and control group received placebo at the same condition. The Data were analyzed using Mann–Whitney U and Kruskal–Wallis tests.

The success rate of ESWL was 73.0% in the hydrochlorothiazide and 71.7% in the placebo groups (p=0.840). Duration of stone passage in hydrochlorothiazide group was 5.49 ± 2.92 days and in placebo was 6.46±3.98 days (p=0.147). In hydrochlorothiazide group, duration of stone passage in patients with stone size of 16-20 mm was less than patients with stone size smaller than 16 mm (p=0.024). In patients aged 19-35 years old, duration of stone passage in hydrochlorothiazide group (p=0.004) and in the right renal pelvis stone (0.049) was less than placebo. 

The hydrochlorothiazide reduced the stone passage time after ESWL clinically, although not statistically significant. Considering the effectiveness of hydrochlorothiazide in passage of stones in young patients with renal stones of smaller size, it would be among medical interventions in nephrolithiasis.