Low-dose thiazide diuretics in children with idiopathic renal hypercalciuria

Acta Paediatr. 2011 Aug;100(8):e71-4. doi: 10.1111/j.1651-2227.2011.02191.x. Epub 2011 Mar 1.


Aim: To evaluate the therapeutic effect of hydrochlorothiazide in idiopathic renal hypercalciuria.

Methods: We retrospectively analysed the data of 28 children (6.0±4.1 years, M:F=19:9) diagnosed as having idiopathic renal hypercalciuria from the years 1991 to 2008. The dose of hydrochlorothiazide was initially 0.5 mg/kg/day and gradually increased to achieve the appropriate hypocalciuric effect (urinary calcium/creatinine<0.2 mg/mg) in some unresponsive patients.

Results: Twenty-two patients (79%) had gross haematuria, 6 (21%) microscopic haematuria, 2 left flank pain, 6 (21%) urolithiasis and 9 (32%) urinary tract infection at the diagnosis of hypercalciuria. The low doses (0.5 mg/kg/day) of hydrochlorothiazide reduced urinary calcium excretion in 25 patients (89%) and 3 (11%) required the increased doses (1-2 mg/kg/day). Haematuria and urolithiasis gradually resolved in accordance with the improvement of hypercalciuria. Nineteen patients (68%) maintaining hypocalciuria during hydrochlorothiazide therapy were discontinued after 12.5±5.3 months of treatment. Eleven of the 19 patients maintained normocalciuria, while 8 showed increased urinary calcium excretion at 2.9±2.3 months after treatment was stopped, requiring thiazide retreatment.

Conclusion: Our results suggest that low dose (0.5 mg/kg/day) of hydrochlorothiazide may be safe and effective in controlling renal hypercalciuria in children.

MeSH terms

  • Child
  • Diuretics / administration & dosage*
  • Female
  • Hematuria / etiology
  • Humans
  • Hydrochlorothiazide / administration & dosage*
  • Hypercalciuria / drug therapy*
  • Hypercalciuria / etiology
  • Kidney Diseases / complications
  • Kidney Diseases / drug therapy*
  • Male
  • Sodium Chloride Symporter Inhibitors / administration & dosage*


  • Diuretics
  • Sodium Chloride Symporter Inhibitors
  • Hydrochlorothiazide