Mohammad Zakeri Ghazaani
1 
, Fatemeh Sadat Damanpak Rizi
1 , Elena Malekpour
2 , Elham Momeni
3 , Fatemeh Abbasi
4* 1 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
3 Shahid Beheshti Hospital, Isfahan, Iran
4 Department of Obstetrics and Gynecology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Kidney stones constitute a distressing and often recurring condition with increasing prevalence in the last decades. Despite successful outcomes following kidney stone treatment, the recurrence rate remains notably high. Thiazides have conventionally been the mainstay for preventing kidney stone recurrence, with studies exploring their efficacy at various doses. The NOSTONE study is an exceptional placebo-controlled randomized controlled trial on the effectiveness of different doses of hydrochlorothiazide in preventing kidney stones. Notably commendable for its methodological rigor and comprehensive approach, the study serves as a noteworthy contribution to advancing our understanding of kidney stone prevention strategies. Our study provides a critical evaluation of the NOSTONE study’s investigation into the effectiveness of hydrochlorothiazide in preventing the recurrence of kidney stones, with a primary emphasis on the statistical flaws identified within the NOSTONE study.
Implication for health policy/practice/research/medical education:
Kidney stones represent a disease with a rising prevalence and a notable recurrence rate. Thiazides have long been prescribed to mitigate recurrence; however, studies assessing their effectiveness in varied doses for preventing kidney stone recurrence have consistently faced limitations. The NOSTONE study has numerous strengths, but some limitations warrant scrutiny, particularly in analysis and statistical outcomes. Such examination can significantly contribute to refining future recommendations to prevent kidney stone recurrence.
Please cite this paper as: Zakeri Ghazaani M, Damanpak Rizi FS, Malekpour E, Momeni E, Abbasi F. Hydrochlorothiazide and kidney stone recurrence; an in-depth analysis of the NOSTONE trial. J Renal Inj Prev. 2024; 13(3): e32279. doi: 10.34172/jrip.2024.32279.