New research may help mitigate kidney stone pain.
Researchers at Cambridge’s Massachusetts Institute of Technology (MIT) may have found a combination of medicines that can ease the pain of going through a kidney stone. In pigs, they performed their research.
Anyone who has ever gone through a stone of the kidney knows it can be a painful experience.
More than half a million people in the U.S. experience this pain every year, and at some point about 1 in 10 people will have a kidney stone.
According to a new study in Nature Biomedical Engineering, however, the experience may soon be a thing of the past.
The research team has found a combo of two drugs that can relax porcine ureters ‘ walls. Such drugs may potentially prevent kidney stones in humans from causing such severe pain.
Prof. Michael Cima, the senior author of the study, states, “We think this could significantly impact kidney stone disease, which affects millions of people.”
Prof. Cima works with the Science and Engineering Department of Materials at MIT and the Koch Institute for Integrative Cancer Research at the school.
Once urine that usually washes crystals from the kidneys is produced, the stones contain too much solid waste and not enough liquid to do the job.
These crystals clump together, forming stones that painfully force the narrow ureter down, causing cramps and inflammation. Most pass in a couple of weeks, though the pain may be consistent and severe. Large stones also need surgical removal.
Because the Food and Drug Administration (FDA) has yet to approve the use of any oral medication to expand the ureter and help pass the stones, doctors still simply prescribe drugs for pain relief.
Other studies have previously tested ureter relaxants, but the drugs have not been conclusively helpful.
The lead author of the study is Christopher Lee, Ph.D., of the Joint Department of Harvard-MIT Health Sciences and Technology. He defines the new research’s motivation: “If you look at how kidney stones are treated today, it hasn’t really changed since about 1980, and there’s a pretty substantial amount of evidence that the drugs given don’t work very well. The volume of how many people this could potentially help is really exciting.”
Prof. Cima and Dr. Brian Eisner, the latter co-author of the study and urologist specializing in kidney stones.
However, Prof. Cima notes, “We found several drugs that had the effect that we expected, and in every case, we found that the concentrations required to be effective were more than would be safe if given systemically.”
The researchers further analyzed their findings, seeking a combination of two drugs that could be effective at lower, safer doses. They eventually found two top-performing drugs that, when administered together, could produce even more positive results.
Nifedipine is one of the drugs that is a calcium channel blocker that can be used by doctors to treat high blood pressure. The other is an inhibitor of Rho kinase that is able to treat glaucoma.
The team then delivered different dosages of the mixture to ureters through a tubular tool called a cystoscope that had been removed from pigs.
To gauge their effectiveness at relieving the ureter tissue, the researchers tracked the frequency and duration of contractions, or cramps, associated with passing the stones.
Later tests in live, sedated pigs showed that these contractions could be almost eliminated by the combination of drugs.
However, subsequent tests find no traces in the bloodstream of either drug. The implication is that this drug remains in the ureter, which reduces the risk of systemic side effects.
The researchers hope to carry out further research and development, leading ultimately to human trials.


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