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A recent study published in JAMA Network Open has revealed that higher doses of thiazide diuretics can significantly reduce the frequency of symptomatic kidney stone events. Researchers found that these higher doses lead to more substantial reductions in urine calcium levels, a key factor in the formation of kidney stones.
The study, which analyzed data from the Medicare-Litholink Database, included 634 adults with a mean age of 67.6 years who were prescribed thiazide diuretics, such as hydrochlorothiazide, chlorthalidone, or indapamide. The participants underwent urine collections during follow-up visits after receiving their prescriptions. The doses of thiazides were categorized as low, medium, or high, and their impact on urine calcium levels was carefully evaluated.
The results showed a clear dose-dependent effect on urine calcium reduction. Individuals who received low doses of thiazide experienced an 18.9% reduction in calcium levels, while those on medium doses had a 25.5% reduction. The highest doses resulted in a 28.4% decrease in urine calcium. More importantly, these reductions were linked to a decrease in the occurrence of symptomatic kidney stone events over a four-year period.
The study further found that the cumulative incidence of kidney stone events was 28.8% among patients with low reductions in calcium levels, compared to just 19.5% for those with medium reductions and 18.0% for those with high reductions. These findings suggest that adjusting thiazide dosage could be a crucial strategy in preventing kidney stones, particularly for individuals at higher risk of developing them.
This research underscores the importance of tailored treatment approaches in managing kidney stone risk and highlights the potential benefits of optimizing thiazide dosage to achieve the best outcomes in kidney stone prevention.
