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Risk of bias summary: review authors' judgments about each risk of bias item for each included study (single study).
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Figure 1

Risk of bias summary: review authors' judgments about each risk of bias item for each included study (single study).

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Study flow diagram.
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Figure 2

Study flow diagram.

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Risk of bias graph: review authors' judgments about each risk of bias item presented as percentages across all included studies (single study).
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Figure 3

Risk of bias graph: review authors' judgments about each risk of bias item presented as percentages across all included studies (single study).

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Comparison 1 Potassium citrate versus no treatment, Outcome 1 Stone recurrence and regrowth.
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Analysis 1.1

Comparison 1 Potassium citrate versus no treatment, Outcome 1 Stone recurrence and regrowth.

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Comparison 1 Potassium citrate versus no treatment, Outcome 2 Adverse events.
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Analysis 1.2

Comparison 1 Potassium citrate versus no treatment, Outcome 2 Adverse events.

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Summary of findings for the main comparison. Potassium citrate compared to no intervention for preventing urinary stones in children

Patient or population: children with idiopathic urinary calculi treated with shockwave lithotripsy
Setting: likely outpatient
Intervention: potassium citrate
Comparison: no intervention

Outcomes

No of participants
(studies)

Quality of the evidence
(GRADE)

Relative effect
(95% CI)

Anticipated absolute effects* (95% CI)

Risk with no intervention

Risk difference with medical or dietary interventions

Proportion of participants who developed a new urinary stone
follow‐up: mean 24.4 months

96
(1 RCT)

⊕⊕⊝⊝
Low1

RR 0.19
(0.06 to 0.60)

Study population

333 per 1000

270 fewer per 1000
(133 fewer to 313 fewer)

Proportion of participants with adverse events while undergoing intervention

follow‐up: mean 24.4 months

96
(1 RCT)

⊕⊝⊝⊝
Very low1,2,3

RR 13.00
(0.75 to 224.53)

Study population

‐

‐

Proportion of participants undergoing retreatment for urinary stones

no information found

NA

NA

NA

NA

*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).

CI: confidence interval; RCT: randomized controlled trial; RR: risk ratio; NA: not applicable (since no information found).

GRADE Working Group grades of evidence
High quality: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.
Very low quality: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.

1Downgraded by two levels for study limitations: almost all domains were unclear or high risk of bias.

2Downgraded by two levels for imprecision: very rare event resulting in very wide confidence interval.

3No event in control arm.

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Summary of findings for the main comparison. Potassium citrate compared to no intervention for preventing urinary stones in children
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Comparison 1. Potassium citrate versus no treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Stone recurrence and regrowth Show forest plot

1

96

Risk Ratio (M‐H, Random, 95% CI)

0.19 [0.06, 0.60]

2 Adverse events Show forest plot

1

96

Risk Ratio (M‐H, Random, 95% CI)

13.00 [0.75, 224.53]
Figuras y tablas -
Comparison 1. Potassium citrate versus no treatment
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