Introduction: Toanalyzetheroleof Hydrochlorothiazide (HCTZ) in pediatric stone formers with hypercalciuria urolithiasis considering hypocalciuric action of the drug and to define possible factors affecting response to HCTZ.Methods: In a 2 years period (2007 to 2008), 19 pediatric stone formers with idiopathic hypercalciuric urolithiasis prospectively were evaluated at a single academic center. Patients were followed every 2 to 3 months by checking urine specific gravity, urine PH and urine calcium and Cr excretion (in 24 hour or random urine) as well as renal ultra sonography (US). HCTZ was recommended in a dosage of 1 to 2 mg/kg/d with polycitra-potassium (combination of citric-acid and potassium citrate) 1 meq/kg/d.Results: Of 19 patients 12 (63.2%) were female and 7 (36.8%) were male (F/M = 1.7). 11 patients (57.2%) had a history of urolithiasis in their relatives and 7 (36.4%) did not have any family history of stone. In 2 cases the family history was unknown. Patients received HCTZ for 2.5 to 15 months (6 ± 3 months). Seven (36.8 %) patients reached normacalciuria. Resolution of hypercalciuria associated with decreased stones sizes was seen in 1 (5.3%) and stone free condition in 4 (20 %) patients. In 3 patients, although urinary calcium excretion reached the normal limits, stones sizes didn’t change during follow up.Conclusion: Although approximately in 50% of patients after treatment with HCTZ Ca excretion rate returned to normal range, it accompanied stone size changes in 5 (26.2%). Interestingly all the 5 patients with favorable response were female. According to our study, combinations of diet modification and HCTZ has reasonable hypocalciuric effects, but it’s not efficient in stopping stone formation process.

We read with interest the article "Role of high-dose Hydrochlorothiazide in idiopathic hypercalciuric urolithiasis of childhood" by Naseri and Sadeghi. They used high-dose Hydrochlorothiazide (1 mg/ kg/d to 2 mg/kg/d) in hypercalciuric children and described that no study has addressed whether low doses of thiazides have a hypocalciuric effect, especially in children. We recently reported that a low dose (0.5 mg/kg/d) of Hydrochlorothiazide may be safe and effective in controlling renal hypercalciuria in children and found that hematuria and urolithiasis gradually resolved in accordance with the improvement of hypercalciuria.

Introduction: Hypercalciuria is one of the most common metabolic factors responsible for stone formation in pediatric stone formers.This study was designed to analyze the role of Hydrochlorothiazide (HCTZ) in pediatric stone formers with hypercalciuric urolithiasis considering hypocalciuric action of the drug and to definepossible factors affecting response to the drug.Methods: In a 2 year period (2007 to 2008), 19 pediatric stone formers with idiopathic hypercalciuric urolithiasis prospectively were evaluated at a single academic center. Patients followed every 2 to 3 months by checking urine specific gravity, urine PH and urine calcium and Cr excretion (in 24-hour or random urine) and renal Ultrasonography (US).HCTZ was recommended in a dosage of 1 to 2 mg/kg/d with polycira-potassium (combination of citric-acid and potassium citrate) 1 meq/Kg/d.Results: Out of 19 patients, 12 (63.2%) were female and 7 (36.8%) were male (F/M ratio=1.7). Eleven patients (57.2%) had a history of urolithiasis in their relatives and 7 (36.4%) did not have any family history of stone. In 2 cases, the family history was unknown. Patients received HCTZ for 2.5 to 15 months (6 ± 3 months). Seven patients (36.8%) reached normocalciuria. Resolution of hypercalciuria associated with decreased stones sizes was seen in 1 (5.3%) and stone free condition in 4 (20%) patients. In 3 patients, although urinary calcium excretion reached the normal limits, stones sizes did not change during follow up.Conclusions: Although approximately in 50% of patients after treatment with HCTZ, calcium excretion rate returned to normal range, stone size changes seen in 5 (26.2%). Interestingly, all 5 patients with favorable response were female. According to our study, combination of diet modification and HCTZ has reasonable hypocalciuric effects, but it is not efficient in stopping stone formation process

Introduction. The aim of this study was to evaluate the role of Hydrochlorothiazide in pediatric calculus formers with hypercalciuria and define possible factors affecting response to treatment.Materials and Methods.Nineteen pediatric calculus formers, 12 girls and 7 boys, aged 15 days to 60 months, with idiopathic hypercalciuria received high-dose Hydrochlorothiazide (1 mg/ kg/d to 2 mg/kg/d) and citric acid-potassium citrate (1 mEq/ kg/d) and were evaluated in a 2-year period. Avoiding high-salt diets was recommended throughout the study and increasing fluid intake was encouraged.Results. The patients received Hydrochlorothiazide for 2.5 to 15 months (mean, 6±3 months), and 10 of them (52.6%) reached normacalciuria. Resolution of hypercalciuria was associated with decreased calculi sizes in 1 (5.3%) and stone-free condition in 4 (21.1%). No significant differences were found between responders and nonresponders with regard to age at presentation, gender, family history of calculus, and size and number of calculi.Conclusions. Our study showed that a combination of diet modification and Hydrochlorothiazide has reasonable hypocalciuric effects; however, it is not very efficient in stopping calculus formation process. In addition, clinical and radiological data were not helpful to predict patients with better response to treatment.

Introduction: Hydrochlorothiazide is widely prescribed for managing hypertension. Despite its extensive use, there is a significant lack of scientific literature addressing its impact on 24-hour urine parameters. This study aims to investigate these effects by comparing parameters derived from 24-hour urine collection tests before and after Hydrochlorothiazide administration.Methods: This prospective before-and-after study was conducted from 2021 to 2022 at the medical facilities affiliated with the Islamic Azad University, Tehran Medical Sciences Branch. Adhering to university-approved research protocols, participants were instructed to provide 24-hour urine samples before initiating Hydrochlorothiazide treatment. One week later, a second set of 24-hour urine samples was collected following the administration of Hydrochlorothiazide. This methodology allowed for the comparison of urine parameters before and after the intervention.Results: Among the eight variables analyzed—volume, protein, creatinine, albumin, uric acid, citrate, and pH—six showed P-values greater than 0.05, indicating no statistically significant differences between the pre-and post-treatment tests. However, calcium and citrate levels exhibited P-values less than 0.05, indicating a significant decrease in their mean values following Hydrochlorothiazide administration.Conclusion: The study findings show a significant impact of HCTZ on urinary calcium and citrate levels, with both parameters demonstrating a statistically significant decrease after treatment.