LAUSR

To the editor, We read the interesting article recently published by Kapila et al. entitled ‘The analgesic action of desmopressin in renal colic’ and wish to share our comments regarding their results [1]. According to their findings, authors have suggested a potential analgesic effect for desmopressin in nephrolithiasis pain management. The authors noted that due to low quality of conducted studies, there is a need for a meta-analysis to reach a conclusion regarding the efficacy of desmopressin in treatment of renal colic. Although authors highlighted the requirement for meta-analysis to reach a consensus with regard to the use of desmopressin in renal colic pain management, they were unable to conduct that in their review. We can propose some reasons for that. Heterogeneity among results of included studies was too substantial regarding variables such as dose and rout of desmopressin administration, type of analgesic medication used in studies, and patient population. For the first time in 2016, we conducted a meta-analysis on 10 studies to compare the impact of desmopressin with opioids and non-steroidal anti-inflammatory drugs (NSAIDs) on pain management in nephrolithiasis patients [2]. We observed that desmopressin alone, does not provide any significant analgesic effect compared to opioids and NSAIDs. However, we demonstrated that desmopressin, as an adjuvant therapy, significantly improves the analgesic effect of opioids; nevertheless, such effect was not observed in combination therapy of desmopressin with NSAIDs.