Higher thiazide doses shown to reduce kidney stone events

Higher thiazide doses are related to higher reductions in urine calcium, which in flip correlate with fewer symptomatic kidney stone occasions, based on a Vanderbilt University Medical Center (VUMC) examine revealed in JAMA Network Open.

Thiazide diuretics, generally prescribed to forestall kidney stone recurrence, are medicine that act instantly on the kidneys to advertise diuresis (urine move) by inhibiting the sodium/chloride cotransporter positioned within the distal convoluted tubule of a nephron (the practical unit of a kidney). Thiazides are additionally used as a standard therapy for hypertension and to clear fluid from the physique in circumstances comparable to coronary heart failure.

First creator Ryan Hsi, MD, FACS, affiliate professor within the Department of Urology at VUMC, stated the examine knowledge assist clarify the findings of the multicenter Hydrochlorothiazide for Kidney Stone Recurrence Prevention (NOSTONE) trial, which reported that hydrochlorothiazide didn’t scale back recurrence of kidney stone occasions.

“In mild of our analysis, the calcium reductions in that examine have been modest and sure inadequate to have an effect on recurrence danger,” Hsi stated.

“What this implies for sufferers is that thiazides stay an vital possibility within the toolkit for stopping kidney stone recurrence. It could also be helpful to watch calcium excretion whereas on thiazide remedy to regulate dose and weight loss plan to achieve an ample discount in urine calcium.”

A complete of 634 individuals have been studied, revealing vital associations between greater thiazide doses and urine calcium reductions higher than these achieved within the NOSTONE trial, the place individuals took totally different doses of hydrochlorothiazide.

For subsequent steps, the researchers are excited by understanding which subtypes of thiazides and their dosing work finest, and the way finest to optimize remedy adherence, since these therapies are sometimes administered long run.