Which drug can be prescribed for idiopathic hypercalciuria?
Alternatively, a potassium sparing diuretic such as amiloride can be added to further reduce hypercalciuria. 150 The potassium sparing diuretic, triamterene, should be …
Is metolazone used for idiopathic hypercalciuria?
VIDEO: About 27 minutes with a break at 15 minutes. Perhaps the most common abnormality among calcium stone formers, idiopathic hypercalciuria (IH) causes calcium kidney stones and can lead to bone mineral loss and fracturing bone disease. Proper treatment requires a high calcium intake, a low sodium intake, moderation of very high protein ...
How is hypercalciuria treated?
Jun 02, 2021 · Diuretics, Thiazide. Class Summary. Thiazide diuretics are used in patients with hypercalciuria that is not adequately controlled with dietary modifications alone. Thiazide diuretics are also used...
What is idiopathic hypercalciuria?
Apr 05, 2022 · Thiazides are specifically indicated for patients with renal leak hypercalciuria, in whom they not only reduce the inappropriate renal calcium loss but also lower parathyroid hormone (PTH) levels...
Which drug is used in treatment of hypercalciuria?
Thiazides. Thiazides are currently the mainstay of medical therapy for hypercalciuria. These agents do not directly affect intestinal calcium absorption but instead stimulate calcium reabsorption in the distal renal tubule.Jun 2, 2021
How is idiopathic hypercalciuria treated?
Proper treatment requires a high calcium intake, a low sodium intake, moderation of very high protein intakes, avoidance of refined sugar loads, and – not rarely – use of diuretic drugs which can lower urine calcium losses, prevent stones, and protect bones.
Which drug is strongest diuretic?
Loop diuretics are the most potent diuretics as they increase the elimination of sodium and chloride by primarily preventing reabsorption of sodium and chloride.
What is idiopathic hypercalciuria?
Idiopathic hypercalciuria (IH), defined as an excess urine calcium excretion without an apparent underlying etiology, is the most frequent cause of hypercalciuria and will be the focus of this paper.
What causes idiopathic hypercalciuria?
High sodium intake has been proposed as the cause of idiopathic hypercalciuria. High sodium intake leads to increased urinary sodium excretion, and the increased tubular sodium load can decrease tubular calcium reabsorption, possibly favoring a reduction in bone mineral density over time.Jan 1, 2018
What drug decreases calcium excretion in urine?
Potassium citrate decreases urine calcium excretion in patients with hypocitraturic calcium oxalate nephrolithiasis. Urolithiasis.
Which is better furosemide or spironolactone?
These results indicate that (a) at the dosages used in the study, spironolactone is more effective than furosemide in nonazotemic cirrhosis with ascites, and (b) the activity of the renin-aldosterone system influences the diuretic response to furosemide and spironolactone in these patients.
Which is better Lasix or Torsemide?
Furosemide (Lasix) is the most widely used diuretic in heart failure patients. Torsemide (Demadex) has a better pharmacokinetic and pharmacodynamic profile than does furosemide, with greater bioavailability, a longer half-life, and higher potency.May 3, 2021
Which is better Lasix or hydrochlorothiazide?
Both hydrochlorothiazide and furosemide significantly reduced blood pressure (BP) during three months of therapy. However, the fall in BP was consistently greater with hydrochlorothiazide than with furosemide, although the difference was significant only with respect to systolic BP.
How common is idiopathic hypercalciuria?
Idiopathic hypercalciuria (IH) affects 5 to 7% of adults and children and is the single most common cause of Ca oxalate kidney stone formation and also causes low bone mass. All of the metabolic features of IH can be reproduced by the administration of calcitriol to normal adults.
What diseases cause hypercalciuria?
Causes of hypercalciuria that need to be considered include the following:Hyperthyroidism.Renal tubular acidosis.Sarcoidosis and other granulomatous diseases.Vitamin D intoxication.Glucocorticoid excess.Paget disease.Albright tubular acidosis.Various paraneoplastic syndromes.More items...•Jun 2, 2021
What happens if hypercalcemia is left untreated?
If left untreated, hypercalcemia can lead to serious complications. For example, if the bones continue to release calcium into the blood, osteoporosis, a bone-thinning disease, can result. If urine contains too much calcium, crystals may form in the kidneys. Over time, these crystals may combine to form kidney stones.Dec 2, 2011
What is the best treatment for hypercalciuria?
Dietary modifications have long been the mainstay of initial therapy for hypercalciuria. All hypercalciuric patients are advised to follow reasonable dietary changes to help limit their urinary calcium loss, reduce stone recurrences, and improve the effectiveness of medical therapy.
How to reduce calcium oxalate?
Limit alcohol and caffeine intake. Increase fluid intake, especially water (sufficient to produce at least 2 L of urine per day) Dietary modifications involving reasonable restrictions of dietary calcium, oxalate, meat (purines) and sodium, have been useful in reducing the urinary supersaturation of calcium oxalate.
What foods have oxalate?
Common foods with relatively high oxalate content include nuts, chocolate, colas, vegetables, rhubarb, spinach, collard greens, tea, and green, leafy vegetables. Several large population studies have investigated the issue of the potential contribution of a high-carbohydrate diet to stone production.
How does animal protein affect urinary calcium?
Animal protein affects urinary calcium mainly through its acid-loading ability. Animal protein is high in purines, which are metabolized to uric acid, contributing to the acid load. Animal protein also increases the body's acid load directly.
What are the criteria for dietary factors to be implicated in kidney stone disease?
Some have suggested that the following 3 criteria need to be fulfilled for any dietary factor to be implicated in kidney stone disease: Intake of the dietary constituent should be increased in patients with stones compared with controls. Restriction of the dietary factor should decrease stone formation rates.
Does orthophosphate lower calcium?
Overall, orthophosphates lower 24-hour urinary calcium excretion by about 50% in patents with absorptive hypercalciuria and by about 25% in patients with other hypercalciuric states. No apparent effect on PTH levels exists in healthy individuals.
What happens when sulfur is oxidized to sulfate?
When the sulfur is oxidized to sulfate, additional acid is generated. (Sulfate also can form a soluble complex with calcium in the renal tubules, reducing calcium reabsorption and contributing to hypercalciuria.) Excess acid needs to be neutralized.
What is the threshold for hypercalciuria?
The threshold of clinical hypercalciuria, 200 mg/day, resides at about the 75th percentile: 25% of normal people are above it. But stone formers are perhaps 7-10% or less of the human population. So hypercalciuria raises stone risk, but not everyone gets the stones.
How much calcium does a person with IH excrete?
Normal people excrete about 2% or less of filtered calcium, those with IH excrete 4% to 5% or more.
How does the kidney work with sodium?
As you eat more sodium, urine sodium goes up so output balances intake. One way the kidney accomplishes this balance is that filtration rises with higher sodium intake. Another is that reclamation of water and sodium in the proximal tubule (the part nearest the glomerular filter) goes down – more sodium and water flow downstream in the nephron. Calcium goes with it, the two are linked by the way that part of the nephron works.
What causes kidney stones?
Perhaps the most common abnormality among calcium stone formers, idiopathic hypercalciuria (IH) causes calcium kidney stones and can lead to bone mineral loss and fracturing bone disease. Proper treatment requires a high calcium intake, a low sodium intake, moderation of very high protein intakes, avoidance of refined sugar loads, and – not rarely – use of diuretic drugs which can lower urine calcium losses, prevent stones, and protect bones.
What is the best diet for calcium stones?
The proper diet for prevention of the common calcium stone arises almost totally from the requirements to treat IH: reduced diet sodium, refined sugar, and protein, and adequate calcium for bone. The last of these, high diet calcium plays another role in stone prevention by lowering urine oxalate.
What does a value of 1 mean?
A value of 1 means no higher than among people with urine calcium below 100 mg/day – the reference population. The lower 95th percentile of risk is at the bottoms of the bars. When the bottom of a solid bar lies above one, which is the case for all bars from 200-249 mg/d on, increased risk is very likely present.
What is the name of the tubule that resembles a woman's hair?
Each kidney tubule resembles a woman’s hair – long as a long hair, and that thin. Down the center of the hair is its lumen through which the filtrate passes to become urine, and where calcium is reclaimed.