Hydrochlorothiazide Does Not Affect Recurrence of Kidney Stones

FRIDAY, March 10, 2023 (HealthDay News) — Hydrochlorothiazide does not reduce the risk for recurrence among patients with recurrent kidney stones, according to a study published in the March 2 issue of the New England Journal of Medicine.

Nasser A. Dhayat, M.D., from Bern University Hospital in Switzerland, and colleagues randomly assigned patients with recurrent calcium-containing kidney stones to receive once-daily hydrochlorothiazide (12.5, 25, or 50 mg) or placebo. A total of 416 patients were randomly assigned and followed for a median of 2.9 years.

The researchers found that a primary end point event (a composite of symptomatic or radiologic recurrence of kidney stones) occurred in 59 percent of 102 patients in the placebo group, 59 percent of 105 patients in the 12.5-mg hydrochlorothiazide group (rate ratio, 1.33; 95 percent confidence interval, 0.92 to 1.93), 56 percent of 108 patients in the 25-mg group (rate ratio, 1.24; 95 percent confidence interval, 0.86 to 1.79), and 49 percent of 101 patients in the 50-mg group (rate ratio, 0.92; 95 percent confidence interval, 0.63 to 1.36). No association was seen between the hydrochlorothiazide dose and the occurrence of a primary end point event. Compared with those receiving placebo, patients who received hydrochlorothiazide more often had hypokalemia, gout, new-onset diabetes mellitus, skin allergy, and a plasma creatinine level exceeding 150 percent of the baseline level.

“The results of our trial show that treatment with hydrochlorothiazide did not appear to differ substantially from placebo in preventing the recurrence of kidney stones in patients at high risk for recurrence,” the authors write.