Mitra Naseri1, Ramin Sadeghi. 1. Department of Pediatric Nephrology, Dr Sheikh Children Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. naserim@mums.ac.ir
Abstract
INTRODUCTION: The aim of this study was to evaluate the role of hydrochlorothiazide in pediatric calculus formers with hypercalciuria and define possible factors affecting response to treatment. MATERIALS AND METHODS: Nineteen pediatric calculus formers, 12 girls and 7 boys, aged 15 days to 60 months, with idiopathic hypercalciuria received high-dose hydrochlorothiazide (1 mg/kg/d to 2 mg/kg/d) and citric acid-potassium citrate (1 mEq/kg/d) and were evaluated in a 2-year period. Avoiding high-salt diets was recommended throughout the study and increasing fluid intake was encouraged. RESULTS: The patients received hydrochlorothiazide for 2.5 to 15 months (mean, 6 ± 3 months), and 10 of them (52.6%) reached normacalciuria. Resolution of hypercalciuria was associated with decreased calculi sizes in 1 (5.3%) and stone-free condition in 4 (21.1%). No significant differences were found between responders and nonresponders with regard to age at presentation, gender, family history of calculus, and size and number of calculi. CONCLUSIONS: Our study showed that a combination of diet modification and hydrochlorothiazide has reasonable hypocalciuric effects; however, it is not very efficient in stopping calculus formation process. In addition, clinical and radiological data were not helpful to predict patients with better response to treatment.
INTRODUCTION: The aim of this study was to evaluate the role of hydrochlorothiazide in pediatric calculus formers with hypercalciuria and define possible factors affecting response to treatment. MATERIALS AND METHODS: Nineteen pediatric calculus formers, 12 girls and 7 boys, aged 15 days to 60 months, with idiopathic hypercalciuria received high-dose hydrochlorothiazide (1 mg/kg/d to 2 mg/kg/d) and citric acid-potassium citrate (1 mEq/kg/d) and were evaluated in a 2-year period. Avoiding high-salt diets was recommended throughout the study and increasing fluid intake was encouraged. RESULTS: The patients received hydrochlorothiazide for 2.5 to 15 months (mean, 6 ± 3 months), and 10 of them (52.6%) reached normacalciuria. Resolution of hypercalciuria was associated with decreased calculi sizes in 1 (5.3%) and stone-free condition in 4 (21.1%). No significant differences were found between responders and nonresponders with regard to age at presentation, gender, family history of calculus, and size and number of calculi. CONCLUSIONS: Our study showed that a combination of diet modification and hydrochlorothiazide has reasonable hypocalciuric effects; however, it is not very efficient in stopping calculus formation process. In addition, clinical and radiological data were not helpful to predict patients with better response to treatment.
Authors: Laura Lucaccioni; Elena Coccolini; Alessandra Dozza; Sante Lucio Cantatore; Alberto Berardi; Barbara Predieri; Lorenzo Iughetti Journal: Acta Biomed Date: 2019-05-23