6. Do IV Fluids Make Stones Pass?

Take Home: It doesn’t appear that the small amount of available evidence supports this practice. If the expected effect was huge, I’d expect to see some hint of it in these small studies.  I’ll still treat dehydration from persistent vomiting with IVF, but I won’t order fluids on everyone up front or have them wait until their fluids are done prior to discharge.



To find out if that last part of the Kidney stone dogma from residency is real, I looked for data on IVF in the passage of Kidney Stones…



Fluids and diuretics for acute ureteric colic

 — Cochrane Database Review from 2012

http://www.bibliotecacochrane.com/PDF/CD004926.pdf

Search Results: They found two studies with a total of 118 patients, and both with methodological issues that compared:

Study 1: 3L IVF over 6 hours vs no fluids

Study 2: 2L IVF to maintenance fluids over 4 hours vs maintenance fluids

NO DIFFERENCE in

  • 1. Hourly Pain Scores
  • 2. Stone Clearance
  • 3. Requirement for Surgical Stone Removal

Conclusions: The thin literature available does not support the efficacy of IVF to assist in patient centered outcomes for kidney stone therapy.

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