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Hydrochlorothiazide, sold under the brand name Hydrodiuril among others, is a diuretic medication used to treat hypertension and swelling due to fluid build-up. [4] Other uses include treating diabetes insipidus and renal tubular acidosis and to decrease the risk of kidney stones in those with a high calcium level in the urine. [4]
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]
Thiazides may be used to treat the symptoms of Dent's disease, an X-linked genetic condition that results in electrolyte imbalance with repeated episodes of kidney stones. A case study of two brothers with the condition, two years of treatment with hydrochlorothiazide reduced the incidence of kidney stones and improved kidney function. [22]
The objective of treating IH is preventing nephrolithiasis or the formation of kidney stones. If blood calcium levels are normal, which can rule out hyperparathyroidism , treatment would begin with adopting a diet of ~800 mg of daily calcium, low salt intake, restricted animal protein intake, and increased net fluid intake. [ 8 ]
Other causes of hypercalcemia include sarcoidosis, tuberculosis, Paget disease, multiple endocrine neoplasia (MEN), vitamin D toxicity, familial hypocalciuric hypercalcaemia and certain medications such as lithium and hydrochlorothiazide.
There are various forms, [2] and some drugs may affect kidney function in more than one way. Nephrotoxins are substances displaying nephrotoxicity. Nephrotoxicity should not be confused with some medications predominantly excreted by the kidneys needing their dose adjusted for the decreased kidney function (e.g., heparin, lithium).
Additionally, hypercalciuria can contribute to kidney stone formation which may present with flank or back pain that comes and goes. It can be painful to pass kidney stones and in extreme cases cause kidney damage. [2] [3] Patients that both form kidney stones and have hypercalciuria are at increased risk for bone loss leading to osteoporosis. [4]
Side effects may include nausea, trouble sleeping, dizziness, feeling light headed with standing, kidney problems, allergies, and muscle cramps. [2] [3] Other serious side effects may include high blood potassium. [2] [3] Use in pregnancy and breastfeeding is not generally recommended. [2] [3] Use in those with significant kidney problems is ...
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