Abstract
Thiazide and thiazide-like diuretics are widely used for the management of hypercalciuria among stone-forming patients. Although the effects of different thiazides should be relatively similar in terms of prevention of stone recurrence, their potency and side effects may differ. However, there is scarce data concerning the metabolic and bone effects of these agents among recurrent nephrolithiasis patients with hypercalciuria. The aim of this update article was to compare our experience in the use of thiazide and thiazide- like diuretics with that of the current literature, concerning their anticalciuric properties and consequent reduction of recurrent stone formation. Their impact on bone mass and potential side effects were also discussed.
Highlights
Kidney stone recurrence can be either symptomatic through multiple episodes of renal colic or manifested as new stone formation of previous stone growth
Idiopathic hypercalciuria represents the most frequent metabolic disorder found in stone formers, affecting approximately 50% of all patients[1], and thiazide and thiazide-like diuretics are widely used for both treatment and prevention of recurrence
The effects of different thiazides should be relatively similar in terms of prevention of stone recurrence or treatment of hypertension, Reilly et al[3] have stressed about evidence-based distinctions with respect to the use and dosage of hydrochlorothiazide (HCTZ) compared to the thiazide-like diuretics such as chlorthalidone (CTD) or indapamide (IDP)
Summary
Kidney stone recurrence can be either symptomatic through multiple episodes of renal colic or manifested as new stone formation of previous stone growth. The effects of different thiazides should be relatively similar in terms of prevention of stone recurrence or treatment of hypertension, Reilly et al[3] have stressed about evidence-based distinctions with respect to the use and dosage of hydrochlorothiazide (HCTZ) compared to the thiazide-like diuretics such as chlorthalidone (CTD) or indapamide (IDP). There is scarce data concerning the metabolic and bone effects of different thiazides among recurrent nephrolithiasis patients with hypercalciuria The aim of this update article was to compile data about the use of thiazides and their potential side effects in hypercalciuric stone formers and provide some personal experience of the authors in this field
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