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Evidence summaries

Pharmacological Interventions for Preventing Complications in Idiopathic Hypercalciuria

In patients with idiopathic hypercalciuria and recurrent stones, the addition of thiazides to a normal or modified diet for short to long periods (five months to three years) appears to reduce the number of stone recurrences and decrease the stone formation rate. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 5 studies with a total of 316 subjects. 4 studies compared thiazides with standard treatment (periodic clinical follow-up and increased water intake) or specific dietary recommendations and 1 study compared potassium phosphate with placebo. There was a significant decrease in the number of new stone recurrences (RR 1.61, 95% CI 1.33 to 1.96; 4 studies, n=285) and in the stone formation rate (number of stones/patient/year, MD -0.18, 95% CI -0.30 to -0.06; 3 studies, n=247) in those treated with thiazides. A slow-release neutral potassium phosphate salt in comparison to placebo for a period of 3 months decreased the excretion of urinary calcium (MD - 86.00 mg/24 h, 95% CI -118.36 to -53.64; 1 study, n=31).

No studies in children were identified and there were no studies investigating the use of drug treatment for those with hypercalciuria but were symptom free.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and lack of blinding).

References

  • Escribano J, Balaguer A, Pagone F, Feliu A, Roqué I Figuls M. Pharmacological interventions for preventing complications in idiopathic hypercalciuria. Cochrane Database Syst Rev 2009 Jan 21;(1):CD004754. [PubMed]

Primary/Secondary Keywords