Higher doses of thiazide diuretics are associated with more significant reductions in urine calcium levels, which are linked to a decreased incidence of symptomatic kidney stones. This suggests that increasing the thiazide dosage might be an effective strategy for preventing kidney stones.
The study, which involved 634 adults with kidney stones (average age 67.6 years; 46.5% women), found that higher thiazide doses led to greater reductions in urine calcium: 18.9% with low doses, 25.5% with medium doses, and 28.4% with high doses (P = .02).
Over a four-year period, the adjusted cumulative incidence of symptomatic stone events was 28.8% for the low-dose group, 19.5% for the medium-dose group, and 18.0% for the high-dose group, showing a trend toward statistical significance (P = .04).
As reported by Medscape.com, experts from the University of California, San Francisco, and other institutions recommend that clinicians identify patients with hypercalciuria and consider aggressive thiazide diuretic treatment to reduce the recurrence of kidney stones. They suggest starting with lower doses and adjusting based on the drug’s effectiveness and side effects.