Category: Clinical Stones: Medical Management

MP10-15 - Renal Stone Prevention Outcome in Patients with Hypercalciuria

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective :

Hypercalciuria is commonly associated with renal stone disease. We present the outcome data of pharmacological intervention with thiazide diuretic on renal stone patients who presented with hypercalciuria.


Methods :

Data was collected from letters and blood and urinary biochemical studies carried out on patients referred to the Metabolic Stone Prevention clinic. Data collection included biometrics, 2 sets of pre-intervention and 1 x post-intervention 24 hour urine biochemistry for Calcium, sodium, Magnesium, potassium, phosphate, oxalate, citrate, creatinine & urea, baseline bloods for fasting bone profile, electrolytes , creatinine, bicarbonate, uric acid, PTH, magnesium and Vitamin D, and stone analysis if available. The data was analysed for outcome following thiazide therapy and dietary measures. Statistical analysis was done using Student’s t-test.


Results :

Available data on 140 patients who attended the metabolic stone investigation clinic between March 2013 and Dec 2017 was collected. 75 (53%) were men with age (mean + SD) 53 + 15 yrs. 73 (52%) patients with age (mean + SD) 51.84 + 13.75 yrs and weight (mean + SD) 84.1 + 16.85 Kg had hypercalciuria. 42 out of 73 (57%) with BMI (mean + SD) 30 + 6 were men and 31 (43%) with BMI (mean + SD) 28 + 4.9 were women. Complete data was available on 37 (50%) hypercalciuric patients. All except 2 (uric acid and cystine) had calcium based stones. All except 2 with hyperparathyroidism were treated with a thiazide diuretic. The 24 hour urinary calcium pre - thiazide therapy was 9.8 + 4.08mmol and post-thiazide was 8.39 + 3.68 mmol. The 24 hour urinary calcium level showed significant decline (p = 0.041) following thiazide treatment.  Stones did not recur in 17 out of 37 (40.64%) patients after a mean follow up of 3.64 + 1.1 yrs and 18 (48.65%) patients were discharged from the clinic.


Conclusions :

Thiazide diuretic significantly reduces hypercalciuria and prevents recurrence of renal stones.  Metabolic investigations in patients with stones can help to identify other treatable metabolic diseases.

Jeetendra RAMESH. Rathod

Speciality DOctor
Darent Valley Hospital, Dartford, Kent, UK
Nottingham, England, United Kingdom

David Ranford

Foundation Doctor
Darent Valley Hospital
Dartford, England, United Kingdom

Ziad Elgaid

Foundation Doctor
Darent Valley Hospital, Dartford, Kent, UK
Dartford, England, United Kingdom

Seshadri Sriprasad

Consultant Urologist and Clinical Director
Darent Valley Hospital, Dartford, Kent, UK
Dartford, England, United Kingdom

Padmini A K Manghat

Consultant Chemical Pathologist and Physician
Darent Valley Hospital, Dartford, Kent, UK
Dartford, England, United Kingdom