Thiazide and thiazide-like diuretics in nephrolithiasis

Abstract Thiazide and thiazide-like diuretics are widely used for the management of hypercalciuria among stone-forming patients. Although the effects of different thiazides should be relatively similar in terms of prevention of stone recurrence, their potency and side effects may differ. However, there is scarce data concerning the metabolic and bone effects of these agents among recurrent nephrolithiasis patients with hypercalciuria. The aim of this update article was to compare our experience in the use of thiazide and thiazide- like diuretics with that of the current literature, concerning their anticalciuric properties and consequent reduction of recurrent stone formation. Their impact on bone mass and potential side effects were also discussed.摘要：噻嗪类利尿剂(Thiazide)与噻嗪样利尿剂(thiazide-like diuretics)被广泛应用于合并高钙尿症的尿路结石患者的临床管理。尽管不同噻嗪类利尿剂在预防结石复发方面的作用大体相近，但其药效强度与不良反应或存在差异。然而，目前关于此类药物在合并高钙尿症的复发性肾结石患者中所产生的代谢与骨骼效应的相关数据仍较为匮乏。本篇最新综述旨在结合现有文献，对比我们在使用噻嗪类及噻嗪样利尿剂方面的临床经验，重点探讨二者的抗高钙尿特性及由此实现的结石复发率降低效果。此外，本文还对这类药物对骨量的影响及其潜在不良反应进行了讨论。