Prevention of calcium nephrolithiasis with low-dose thiazide, amiloride and allopurinol

Giuseppe Maschio, Nicola Tessitore, Angela D'Angelo, Antonia Fabris, Francesco Pagano, Andrea Tasca, Giorgio Graziani, Andriana Aroldi, Maurizio Surian, Giacomo Colussi, Alberto Mandressi, Alberto Trinchieri, Francesco Rocco, Claudio Ponticelli, Luigi Minetti

Research output: Contribution to journalArticle

Abstract

We report 5 years' experience with low-dose hydrochlorothiazide, 50 mg/day and amiloride, 5 mg/day, in 519 patients with recurrent calcium nephrolithiasis. Additional treatment with allopurinol, 100 mg/day, was prescribed for approximately 50 percent of the patients. All patients had active stone formation, having 3,464 stones in 3,126 patient-years (6.67 stones per patient, 1.10 stones per year). Hypercalciuria was present in 65 percent of the patients and hyperuricosuria in 24 percent. The administration of low-dose hydrochlorothiazide was effective in reducing urinary calcium excretion in most patients. It is possible that the hypocalciuric effect of hydrochlorothiazide were enhanced by amiloride, an agent which has been shown to cause hypocalciuria when given alone. Significant side effects requiring discontinuation of the drug were observed in only 5 percent of the patients. During 872.8 patient-years of treatment, only 53 new stones were formed (0.10 stones per patient, 0.06 stones per year) in contrast with the 916 predicted ones. The difference (chi-square) is statistically significant (p <0.001). These results show that the administration of low-dose hydrochlorothiazide and amiloride, either alone or in association with allopurinol, is clinically effective in reducing the rate of recurrence of calcium nephrolithiasis.

Original languageEnglish
Pages (from-to)623-626
Number of pages4
JournalAmerican Journal of Medicine
Volume71
Issue number4
DOIs
Publication statusPublished - 1981

ASJC Scopus subject areas

  • Nursing(all)

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    Maschio, G., Tessitore, N., D'Angelo, A., Fabris, A., Pagano, F., Tasca, A., Graziani, G., Aroldi, A., Surian, M., Colussi, G., Mandressi, A., Trinchieri, A., Rocco, F., Ponticelli, C., & Minetti, L. (1981). Prevention of calcium nephrolithiasis with low-dose thiazide, amiloride and allopurinol. American Journal of Medicine, 71(4), 623-626. https://doi.org/10.1016/0002-9343(81)90215-1