Acute renal colic / renal stones – problematic common disease. Current knowledge on etiology, diagnosis and treatments
Keywordsacute renal colic, renal colic treatment, anti-inflammatory drugs, renal stones fluid therapy
An attack of renal colic as a result of kidney stones is one of the most common urological emergencies, with a wide spectrum of severity that generates high morbidity and high health costs. However, there is no single pharmacological treatment regimen for its acute phase. Renal colic is described as one of the worst types of pain, and effective analgesia in the shortest possible time is of paramount importance
Aim of the study:
Summary of current knowledge on the treatment of Acute renal colic / renal stones. The main purpose of our work is to review and summarize the various recommended options for the treatment of acute renal colic attack and prevention of recurrent urolithiasis depending on the type of stones and also to price the efficacy and safety profile of various drugs used in this ailment and to propose a practical treatment regimen.
Material and methods:
We conducted a literature search in PubMed using the terms "acute renal colic," "renal colic treatment," "anti-inflammatory drugs," "renal stones," and "fluid therapy." The most relevant clinical trials, meta-analyses and systematic reviews published from January 1, 2017 to January 1, 2022 in English and Spanish were reviewed.
In various studies reviewed, non-steroidal anti-inflammatory drugs (NSAIDs) show better pain control, with lower doses and fewer side effects than treatment with opioids.
Complete cure in kidney stones is rare due to the frequent recurrence of the disease. Although acute attacks of renal colic are rare in the patients studied, many patients show improvement after taking nonsteroidal anti-inflammatory drugs. Opioids and fluid therapy are reserved for subsequent lines of treatment and also have proven benefits in relieving symptoms.
Silva S, Almeida M, Rodrigues L, Costa M. Acute renal colic: Beyond kidney stones. Nefrologia. 2016;36(2):182-184. doi:10.1016/j.nefro.2015.09.001
Holdgate A, Pollock T. Systematic review of the relative efficacy of non-steroidal anti-inflammatory drugs and opioids in the treatment of acute renal colic. BMJ. 2004 Jun 12;328(7453):1401. doi: 10.1136/bmj.38119.581991.55. Epub 2004 Jun 3. Erratum in: BMJ. 2004 Oct 30;329(7473):1019. PMID: 15178585; PMCID: PMC421776.
Pinheiro JM. Cólica renal [Renal colic]. Acta Med Port. 1999;12(1-3):9-11.
Holdgate A, Pollock T. Nonsteroidal anti-inflammatory drugs (NSAIDs) versus opioids for acute renal colic. Cochrane Database Syst Rev. 2005;2004(2):CD004137. Published 2005 Apr 18. doi:10.1002/14651858.CD004137.pub3
Papadopoulos G, Bourdoumis A, Kachrilas S, Bach C, Buchholz N, Masood J. Hyoscine N-butylbromide (Buscopan®) in the treatment of acute ureteral colic: what is the evidence?. Urol Int. 2014;92(3):253-257. doi:10.1159/000358015
Schmit A, Björkman S, Åkeson J: Preoperative rectal diclofenac versus paracetamol for tonsillectomy: effects on pain and blood loss. Acta Anaesthesiol Scand 2001;45:48-52.
Sostres C, Gargallo CJ, Arroyo MT, Lanas A: Adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs, aspirin and coxibs) on upper gastrointestinal tract. Best Pract Res Clin Gastroenterol 2010;24:121-132.
Montiel-Jarquín ÁJ, Rocha-Rocha VM, Solís-Mendoza HA, Romero-Figueroa MS, Etchegaray-Morales I, Alvarado-Ortega I. Manejo del cólico ureteral con ketorolaco y nifedipina frente a ketorolaco y tamsulosina en el servicio de urgencias [Management of ureteric colic with ketorolac and nifedipin vs. ketorolac and tamsulosin in the emergency room]. Rev Med Inst Mex Seguro Soc. 2017;55 Suppl 1:S20-S25.
Kominsky HD, Rose J, Lehman A, et al. Trends in Acute Pain Management for Renal Colic in the Emergency Department at a Tertiary Care Academic Medical Center. J Endourol. 2020;34(11):1195-1202. doi:10.1089/end.2020.0402
Tu JF, Cao Y, Wang LQ, Shi GX, Jia LC, Liu BL, Yao WH, Pei XL, Cao Y, Li HW, Yan SY, Yang JW, Qu ZC, Liu CZ. Effect of Adjunctive Acupuncture on Pain Relief Among Emergency Department Patients With Acute Renal Colic Due to Urolithiasis: A Randomized Clinical Trial. JAMA Netw Open. 2022 Aug 1;5(8):e2225735. doi: 10.1001/jamanetworkopen.2022.25735. PMID: 35943743; PMCID: PMC9364130.
Türk H, Ün S. Predictive factors for stone disease in patients with renal colic. Arch Ital Urol Androl. 2017;89(2):143-145. Published 2017 Jun 30. doi:10.4081/aiua.2017.2.143
Meltzer AC, Wolfson AB, Mufarrij P, et al. Analgesic and Opioid Use for Patients Discharged from the Emergency Department with Ureteral Stones. J Endourol. 2021;35(7):1067-1071. doi:10.1089/end.2020.0835
López Martínez JM, Sierra Del Rio A, Luque Galvez MP. Medical treatment of renal stones. Tratamiento farmacológico de la litiasis renal. Arch Esp Urol. 2021;74(1):63-70.
Castellano Cristina de la Encarnación , Nebot Àngela Canós , Romeu Juan Pablo Caballero , Llopis Juan Antonio Galán. TRATAMIENTO MÉDICO DEL CÓLICO RENOURETERAL EN SU FASE AGUDA. Archivos Españoles de Urología. 2021, 74(1): 71-79
Kober A, Dobrovits M, Djavan B, Marberger M, Barker R, Bertalanffy P, et al. Local active warming: An effective treatment for pain, anxiety and nausea caused by renal colic. J Urol. 2003;170(3):741–4.
Beltrami P, Guttilla A, Ruggera L, Bernich P, Zattoni F. Renal colic, where is it headed? An observational study. Arch Ital Urol Androl. 2016;88(1):7-12. Published 2016 Mar 31. doi:10.4081/aiua.2016.1.7
Maldonado-Avila M, Del Rosario-Santiago M, Rosas-Nava JE, Manzanilla-Garcia HA, Rios-Davila VM, Rodriguez-Nava P, Vela-Mollinedo RA, Garduño-Arteaga ML. Treatment of reno-ureteral colic by twelfth intercostal nerve block with lidocaine versus intramuscular diclofenac. Int Urol Nephrol. 2017 Mar;49(3):413-417
Tang QL, Wang DJ, Zhou S, Tao RZ. Mirabegron in medical expulsive therapy for distal ureteral stones: a prospective, randomized, controlled study. World J Urol. 2021 Dec;39(12):4465-4470.
Masic D, Liang E, Long C, Sterk EJ, Barbas B, Rech MA. Intravenous Lidocaine for Acute Pain: A Systematic Review. Pharmacotherapy. 2018 Dec;38(12):1250-1259.
Rodger F, Roditi G, Aboumarzouk OM. Diagnostic Accuracy of Low and Ultra-Low Dose CT for Identification of Urinary Tract Stones: A Systematic Review. Urol Int. 2018;100(4):375-385.
Pricop C, Șerban DN, Șerban IL, Cumpanas AA, Puia D. Does silodosin offer better results than tamsulosin as medical expulsive treatment after shock wave lithotripsy for single distal ureteric stones? Wideochir Inne Tech Maloinwazyjne. 2020 Dec;15(4):602-607.
How to Cite
Copyright (c) 2023 Rafał Bakalarczyk, Adrian Rejmer, Natalia Woś, Katarzyna Rojek, Lucjan Bednarz, Karolina Wijas, Kinga Bialic, Karolina Szala-Czerwonka, Artur Bialic, Paweł Majewski
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Number of views and downloads: 174
Number of citations: 0