Tunnicliffe, David J., Mallett, Andrew, Cashmore, Brydee, Mullan, Adam, Lloyd, Lyn, Yip, Adela, Wickham, Ieuan, Hassan, Hicham, Jose, Matthew, and CARI Guidelines Kidney Stones Working Group (2024) Update Thiazide Diuretic Evidence Review for CARI Guidelines Kidney Stones Recommendations. Kidney International Reports, 9 (5). pp. 1145-1148.

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Abstract

[Extract] Recently, a double-blind randomized controlled trial (RCT) NOSTONE compared hydrochlorothiazide (12.5 mg/d, 25 mg/d, 50 mg/d) to placebo in adults with at least 2 episodes of kidney stones (at least 50% calcium oxalate, calcium phosphate, or a mixture of both) within 10 years from 12 centers in Switzerland. The participants in the trial were mostly male (80%), of White ethnicity (99%) with a median age of 49 (interquartile range, 39–55) years, and 63% had hypercalciuria. The study found hydrochlorothiazide had no effect on kidney stone recurrence compared to placebo and no hydrochlorothiazide dose-response relationship over the mean 34 months of follow-up. There was a reduction in radiologic recurrence of kidney stones, and there are concerns regarding the participants’ adherence to recommended high-fluid intake and reduced sodium intake.

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