Thiazide Treatment for Calcium Urolithiasis in Patients with Idiopathic Hypercalciuria

Ohkawa, Mitsuo; Tokunaga, Shuji; Nakashima, Tsutomu; Orito, Matsuo; Hisazumi, Haruo

doi:10.1111/j.1464-410x.1992.tb15624.x

Cited by 110 publications

(43 citation statements)

References 24 publications

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“…Interestingly, in only 2 of 10 RCTs was hypercalciuria an inclusion criterion (9,14). Despite this fact, 7 of 8 trials of adequate duration showed a reduction of kidney stone-formation rate with thiazide diuretics.…”

Section: Thiazide Diuretics and Nephrolithiasismentioning

confidence: 99%

The Evidence-Based Use of Thiazide Diuretics in Hypertension and Nephrolithiasis

Reilly¹,

Peixoto²,

Desir³

2010

Clinical Journal of the American Society of Nephrology

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Thiazide-type diuretics are commonly used in the treatment of hypertension and nephrolithiasis. Evidence from randomized clinical trials needs to be considered in decisions about agent choice and dose. In nephrolithiasis, one of the major limitations of the literature is a paucity of data on the dose-response effect of hydrochlorothiazide (HCTZ) on urinary calcium excretion. The best available evidence for prevention of stone recurrence suggests the use of indapamide at 2.5 mg/d, chlorthalidone at 25 to 50 mg daily, or HCTZ 25 mg twice a day or 50 mg daily. In hypertension, chlorthalidone (12.5 to 30 mg daily) may be the best choice when a diuretic is used for initial therapy, with indapamide (1.5 mg daily) being a valuable alternative for older patients. When adding a thiazide to other drug classes, indapamide (2.5 mg daily) has demonstrated value in hypertensive patients who have had a stroke, and HCTZ (12.5 to 25 mg daily) has a safe track record in several patient groups. Although chlorthalidone has not been tested as add-on therapy, the authors believe it is a safe option in such cases.

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Section: Thiazide Diuretics and Nephrolithiasismentioning

confidence: 99%

The Evidence-Based Use of Thiazide Diuretics in Hypertension and Nephrolithiasis

Reilly¹,

Peixoto²,

Desir³

2010

Clinical Journal of the American Society of Nephrology

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show abstract

“…Randomized-controlled trials have shown reductions in stone recurrence rates of up to 70% with thiazide diuretics [49]. Adverse effects that may offset any benefit are hypokalaemia (associated with reduced citrate excretion), hyperuricaemia, and hyperglycaemia.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

An Update and Practical Guide to Renal Stone Management

et al. 2010

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Renal stone disease covers kidney and lower urinary tract stones caused by a variety of conditions, including metabolic and inherited disorders, and anatomical defects with or without chronic urinary infection. Most cases are idiopathic, in which there is undoubtedly a genetic predisposition, but where environmental and lifestyle factors play an important role. Indeed, it is becoming apparent that renal stone disease is often part of a larger ‘metabolic picture’ commonly associated with type 2 diabetes, obesity, dyslipidaemia, and hypertension. Renal stone disease is a growing problem in the UK (and other developed and developing populations) with a cross-sectional prevalence of ∼1.2%. This means that there are currently ∼720,000 individuals with a history of kidney stones in the UK. Almost 40% of first-time stone formers will form a second stone within 3 years of the first episode if no prophylactic measures are instituted to prevent stone recurrence, since removal or disintegration of the first stone does not treat the underlying cause of stones in the majority of patients. The age of onset is getting younger and the sex ratio (until recently more men than women) is becoming almost even. Metabolic screening remains an important part of investigating renal stone disease, but to the disappointment and frustration of many doctors, medical treatment is still essentially pragmatic, except perhaps in cystinuria, and to a limited extent in primary hyperoxaluria (if pyridoxine-sensitive); although newer treatments may be emerging. This review summarizes current thinking and provides a practical basis for the management of renal stone disease.

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“…There are two placebocontrolled studies with thiazides [45,46], several others with control groups, and follow-up studies of patients with no comparable controls [47][48][49][50][51][52][53][54][55]. In one of the randomized studies thiazide was given together with magnesium and this regimen tended to be more effective than when thiazides were given alone [38].…”

Section: Thiazidementioning

confidence: 99%

Epidemiology and medical management of stone disease

2003

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SUMMARYRecurrent stone formation in the urinary tract is a common and important problem that must be considered in daily urological practice. With a prevalence of> 10% and an expected recurrence rate of ≈ 50%, stone disease has an important effect on the healthcare system. It is generally agreed that patients with uric acid/urate, cystine or infection stones always should be treated pharmacologically. For calcium stone formers the treatment should be chosen according to the severity of the disease. Recurrence in patients with calcium‐stone disease can be prevented with general or specific dietary and drinking advice, and with pharmacological therapy. For idiopathic calcium stone formers the most convincing therapeutic effects have been reported with thiazide and alkaline citrate.

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Thiazide Treatment for Calcium Urolithiasis in Patients with Idiopathic Hypercalciuria

Cited by 110 publications

References 24 publications

The Evidence-Based Use of Thiazide Diuretics in Hypertension and Nephrolithiasis

The Evidence-Based Use of Thiazide Diuretics in Hypertension and Nephrolithiasis

An Update and Practical Guide to Renal Stone Management

Epidemiology and medical management of stone disease

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