Hydrochlorothiazide and kidney stone recurrence; an in-depth analysis of the NOSTONE trial

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.