Role of high-dose hydrochlorothiazide in idiopathic hypercalciuric urolithiasis of childhood

Iran J Kidney Dis. 2011 Jul;5(3):162-8.


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.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Administration, Oral
  • Calcium / urine*
  • Child, Preschool
  • Diuretics / administration & dosage*
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrochlorothiazide / administration & dosage*
  • Hypercalciuria / complications
  • Hypercalciuria / drug therapy*
  • Hypercalciuria / urine
  • Infant
  • Infant, Newborn
  • Male
  • Prospective Studies
  • Time Factors
  • Treatment Outcome
  • Urolithiasis / drug therapy*
  • Urolithiasis / etiology
  • Urolithiasis / urine


  • Diuretics
  • Hydrochlorothiazide
  • Calcium