Metolazone therapy of active calcium nephrolithiasis

  title={Metolazone therapy of active calcium nephrolithiasis},
  author={E. Cunningham and F. H. Oliveros and L. Nascimento},
  journal={Clinical Pharmacology \& Therapeutics},
Metolazone, a nonthiazide diuretic with the hypocalciuric effect of the thiazides, was evaluated in patients with idiopathic calcium nephrolithiasis. During the mean 3‐yr treatment period, there was a 77% decrease in stone incidence in 38 male patients (from 2.10 to 0.49 stones/patient/year). Urine calcium decreased 51% (from 231 ± 19 to 114 ± 7 mg/24 hr after 13 mo therapy). The treatment response was the same when these patients were divided into normocalciuric (n = 23), borderline… Expand
Renal handling of sodium and calcium in hypercalciuria
Despite diuretic and Na restriction most of the patients with hypercalciuria (group II) did not reabsorb Ca in a normal manner, indicative of a severe reabsorptive defect for Ca despite normal Na handling. Expand
Principles and clinical uses of diuretic therapy.
Today's diuretic therapy finds its origins in fortuitous observations on agents first introduced as antimicrobials, which ushered the era of widespread use of diuretics into the practice of medicine. Expand
Etiopathogenesis, clinical manifestations, and management of canine calcium oxalate urolithiasis.
The predominant type of calcium oxalate urolith encountered in dogs is the monohydrate form; however, the dihydrate form may also occur. Expand
Renal calcium metabolism and diuretics.
Diuretic agents have variable effects on calcium excretion as studied in vivo and in isolated kidneys and nephron segments. Generally, by increasing sodium and water excretion, diuretics will cause aExpand
Successful strategies for renal transplantation in primary oxalosis.
It is possible to perform successful renal transplantation in small children and adults with primary oxalosis and to completely prevent the deposition of oxalate in the renal allograft. Expand
Medical evaluation and management of calcium nephrolithiasis.
Because appropriate medical therapy significantly decreases stone recurrence, this disorder must not be ignored by nonurologists and even the single stone-former should be offered a metabolic evaluation. Expand
The pharmacology and therapeutics of diuretics in the pediatric patient.
  • T. Wells
  • Medicine
  • Pediatric clinics of North America
  • 1990
Well-designed clinical trials in neonates, infants, and younger children are necessary prerequisites to safer and more efficacious diuretic therapy, especially in premature neonates. Expand


Prevention of calcium nephrolithiasis with low-dose thiazide, amiloride and allopurinol.
The 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. Expand
The use of thiazides in the prevention of renal calculi.
The efficacy of hydrochlorothiazide, in a usual dosage of 50 mg. twice daily, in preventing further stone formation was evaluated in 67 patients with recurrent calcium stones. Fifty-three of theseExpand
The hypercalciurias. Causes, parathyroid functions, and diagnostic criteria.
The results support the proposed mechanisms for the hypercalciuria and provide reliable diagnostic criteria for the various forms of hyperCalciuria. Expand
Effects of therapy with bendroflumethiazide in patients with recurrent renal calcium stones.
Long-term treatment with thiazides appears to be a safe and effective method for the prevention of recurrent calcium stones and reduces urinary calcium excretion in almost all patients irrespective of their initial urinary calcium level. Expand
Prevention of calcium stones with thiazides.
Thiazides reduce urine oxalate excretion and increase urine zinc and (probably) magnesium; these effects probably contribute to the efficacy of this agent in stone prevention. Expand
Evidence for secondary hyperparathyroidism in idiopathic hypercalciuria.
A reasonable working hypothesis is that idiopathic hypercalciuria is often due to a primary renal defect of calcium handling that leads, by unknown pathways, to secondary hyperparathyroidism. Expand
Recurrence of nephrolithiasis. A six-year prospective study.
  • B. Ettinger
  • Medicine
  • The American journal of medicine
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The absence of renal calcification at entry into the study as well as increasing age were associated with a marked reduction in stone passage, and drug therapy should probably be avoided in older patients aswell as in those who are free of kidney calcifications. Expand
Is selective therapy of recurrent nephrolithiasis possible?
Evidence is provided supporting a selective approach to therapy of nephrolithiasis and the efficacy of special treatment programs chosen on the basis of their ability to correct underlying physicochemical and physiologic derangements. Expand
Effects of metolazone on renal function in normal man.
It was concluded that metolazone had no effect on the distal H + secretory mechanism and did not impair the ability to acidify normally the urine in response to an oral load of NH 4 Cl. Expand
Studies on urolithiasis in Israel.
The composition of 1,000 kidney stones in the authors' area of Israel was analyzed and the predominant stones were a combination of calcium oxalate and calcium phosphate, and uric acid, which was lower in Jews born in Israel than in other ethnic groups. Expand