Higher Thiazide Doses May Help Prevent Kidney Stones: JAMA finds

Thiazide dosages were categorized as, low(Chlorthalidone < 12.5 mg/day; Indapamide < 0.6125 mg/day; Hydrochlorothiazide < 25 mg/day), medium(Chlorthalidone 12.5 to < 25 mg/day; Indapamide 0.6125 to < 1.25 mg/day; Hydrochlorothiazide 25 to < 50 mg/day) and high(Chlorthalidone ≥ 25 mg/day; Indapamide ≥ 1.25 mg/day; Hydrochlorothiazide ≥ 50 mg/day).

Researchers assessed how calcium levels changed with low, medium, and high thiazide dosages and linked these changes to the occurrence of symptomatic kidney stone events, such as emergency visits, hospitalizations, or surgeries, within 6 to 48 months after starting the prescription.

Results revealed that higher thiazide doses were associated with greater reductions in urine calcium levels, with a low dose resulting in an 18.9% reduction, a medium dose in a 25.5% reduction, and a high dose in a 28.4% reduction.

Reference: Hsi RS, Yan PL, Maalouf NM, et al. Thiazide Dose, Urine Calcium, and Symptomatic Kidney Stone Events. JAMA Netw Open. 2024;7(8):e2428953. doi:10.1001/jamanetworkopen.2024.28953