For a patient with idiopathic hypercalciuria and a history of calcium kidney stones who has not normalized 24-hr urine calcium level on thiazide diuretic, is there evidence for targeting a certain urine calcium level for decreased future risk of nephrolithiasis and osteoporosis?

Answer from: at Academic Institution

A good question, and the answer depends on your definition of a "normal" urine calcium level. If you use the standard definition of abnormal, the upper 5 percentile, depending on your laboratory, you will get values for upper normal calciuria in the 250-300 mg per day. However, approximately 10% of ...

Comments

at The University of Iowa
Thank you for your reply. My thought was targetin...

at Mayo Clinic
I have not used chlorthalidone in a 100 mg per day...

at Milwaukee Va Medical Center
I agree with Dr. @Erickson and add the following: ...

at The University of Iowa
Very helpful, thank you for the feedback Dr. @Step...

at Cedars-Sinai Medical Center
Regarding the NOSTONE study, was there no benefit ...

at Mayo Clinic
True, if you use stone passages as your endpoint. ...

at Robert Wood Johnson University Hospital
I think everyone is overlooking the importance of ...

at Mayo Clinic
Absolutely! A urine volume of 2 L per day seems to...

Answer from: at Academic Institution

Great comments, and I agree. I typically target <200 mg/24 hours and focus on a low sodium and low animal protein diet in addition to thiazide diuretics, and I typically use chlorthalidone at 25 or indapamide at 1.25 or 2.5mg depending on their baseline blood pressure. In my calcium phosphate sto...

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For a patient with idiopathic hypercalciuria and a history of calcium kidney stones who has not normalized 24-hr urine calcium level on thiazide diuretic, is there evidence for targeting a certain urine calcium level for decreased future risk of nephrolithiasis and osteoporosis?

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