What is the role of IV hydration in the emergency treatment of nephrolithiasis?

Updated: Jun 21, 2018
  • Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

IV hydration in the setting of acute renal colic is controversial. Whereas some authorities believe that IV fluids hasten passage of the stone through the urogenital system, others express concern that additional hydrostatic pressure exacerbates the pain of renal colic. One small study of 43 ED patients found no difference in pain score or rate of stone passage in patients who received 2 L of saline over 2 hours versus those who received 20 mL of saline per hour. [69]

IV hydration should be given to patients with clinical signs of dehydration or to those with a borderline serum creatinine level who must undergo intravenous pyelography (IVP).


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