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Evidence summaries

Fluids and Diuretics for Acute Ureteric Colic

Fluid therapy might possibly not be effective for pain or for reducing the need for stone removal in adults with uncomplicated acute ureteric colic, but there is insufficient evidence from controlled trials. Level of evidence: "D"

A Cochrane review [Abstract] 1. Two studies (enrolling 118 participants) examined the association between intense hydration and ureteric colic outcomes. There was no significant difference in pain at six hours (1 study, 60 participants: RR 1.06, 95% CI 0.71 to 1.57), surgical stone removal (1 study, 60 participants: RR 1.20, 95% CI 0.41 to 3.51) or manipulation by cystoscopy (1 study, 60 participants: RR 0.67, 95% CI 0.21 to 2.13) when no fluids over six hours was compared to three litres IV fluids administered over a six hour period. There was no difference in stone clearance (1 study 43 participants: RR 1.38, 95% CI 0.50 to 3.84), hourly pain score or patients' narcotic requirements (P > 0.05 for all comparisons) when forced IV hydration of two litres over four hours was compared with minimal IV hydration at 20 mL/hour.

Comment: The quality of evidence was downgraded by sparse data.

    References

    • Worster AS, Bhanich Supapol W. Fluids and diuretics for acute ureteric colic. Cochrane Database Syst Rev 2012;(2):CD004926. [PubMed]

Primary/Secondary Keywords