Topics:
Nephrology • Nephrolithiasis
What is the current recommendation for using thiazide diuretics in patients with calcium oxalate stone disease, given the negative results of the NOSTONE trial?
Answer from: at Academic Institution
This trial will have no effect on my practice. Seven of 10 previous studies of thiazides for stones were positive, as was a meta-analysis. My preference is for the longer-acting drugs indapamide and chlorthalidone; I haven't used HCTZ which is probably a twice-a-day drug, for some years. Note that t...
Sign in or Register to read more
Answer from: at Academic Institution
Agree with @David. The devil is in the details. The subgroup of patients with hypercalciuria was small. Dhayat et al., PMID 36856614 The point estimate (although not stat. sig) moves towards HCTZ 50. Bottom line: (Higher) doses of HCTZ, or (preferably) chlorthalidone, will r...
Answer from: at Community Practice
No stone study raises questions on the routine use of HCTZ to prevent Calcium kidney stones. Despite demonstrating some efficacy in lowering calcium excretion, the study failed to show the benefit of reduction in the risk of recurrent stones.
Despite using a thiazide diuretic and reducing cal...
Answer from: at Community Practice
I have never used HCTZ for stone prevention given short half life. I prefer chlorthalidone or indapamide. In fact for high blood pressure I dont use HCTZ for similar reason