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Kidney stones are primarily composed of calcium salts, with the most common being calcium oxalate (70-80%), followed by calcium phosphate and uric acid. When urine contains high concentrations of these ions, they can form crystals and eventually stones. [41] The formation of kidney stones occurs in three main phases: [41]
Between 1% and 15% of people globally are affected by kidney stones at some point. [14] [15] In 2015, they caused about 16,000 deaths worldwide. [16] Some of the oxalate in urine is produced by the body. Calcium and oxalate in the diet play a part but are not the only factors that affect the formation of calcium oxalate stones. Dietary oxalate ...
Chlortalidone is considered a first-line medication for treatment of high blood pressure. [2] Some recommend chlortalidone over hydrochlorothiazide. [1] [15] A meta-analysis of randomized controlled trials found that chlortalidone is more effective than hydrochlorothiazide for lowering blood pressure, while the two drugs have similar toxicity.
Alkaline citrates are used to prevent recurrent calcium stone formation. [13] [14] [15] [5] This is one of the major types of kidney stones.[16] [17] The citrate salts can increase urine citrate, which binds with urine calcium, reduces supersaturation of calcium salts, and inhibits crystal formation.
Oxalate (systematic IUPAC name: ethanedioate) is an anion with the chemical formula C 2 O 2− 4.This dianion is colorless. It occurs naturally, including in some foods. It forms a variety of salts, for example sodium oxalate (Na 2 C 2 O 4), and several esters such as dimethyl oxalate ((CH 3) 2 C 2 O 4).
Oxalic acid has an oral LD Lo (lowest published lethal dose) of 600 mg/kg. [65] It has been reported that the lethal oral dose is 15 to 30 grams. [66] The toxicity of oxalic acid is due to kidney failure caused by precipitation of solid calcium oxalate. [67] Oxalate is known to cause mitochondrial dysfunction. [68]
Patients with hypothyroidism, diabetes, nephrotic syndrome, dysproteinemia, obstructive liver disease, kidney disease, or alcoholism should consult their doctor before taking this medication. [14] Other drugs should be taken at least one hour before or four to six hours after colestyramine to reduce possible interference with absorption.
24-hour urinary calcium >250 mg/day in women and >300 mg/day in men (see footnote, below) serum calcium > 1 mg/dl above upper limit of normal; Creatinine clearance > 30% below normal for patient's age; Estimated glomerular filtration rate <60 mL/min/1.73 m2; Bone density > 2.5 standard deviations below peak (i.e., T-score of −2.5) People age < 50