The medications used to prevent kidney stones--a condition also known as nephrolithiasis--depend on the type of stones that the individual forms. Most kidney stones are composed of calcium oxalate or uric acid, and a 24-hour urine screen that the patient collects subsequent to the passage of a kidney stone often will include tiny crystals that show the type of stone the individual produces--which will then in turn indicate what medications will best prevent future kidney stones.
Thiazide Diuretics
Thiazide diuretics increase urinary volume and are used to treat individuals who form kidney stones and have certain types of hypercalciuria--excess calcium in the urine--according to research published in 2008 by urologist Gaurav Bandi and colleagues. About 60 percent of all kidney stones are caused by hypercalciuria. Hydrochlorthiazide is one example of a thiazide diuretic. Other examples are chlorthalidone and indapamide.
These diuretics may cause hypokalemia, or low levels of potassium in the blood. Some patients use potassium citrate along with the diuretic to avoid this problem. At other times, a doctor might prescribe a so-called potassium-sparing diuretic instead, such as amiloride.
Allopurinol
The antigout medication allopurinol is sometimes used to treat individuals who form uric acid kidney stones. Sometimes allopurinol is combined with potassium citrate, especially to treat hyperuricosuria--excess levels of uric acid in the urine.
Children sometimes develop kidney or urinary stones, and according to pediatric nephrologist Uri S. Alon at the University of Missouri in Kansas City, allopurinol can sometimes be a second-line therapy to treat this problem, used in combination with the first line treatment, potassium citrate.
Potassium Citrate
Potassium citrate is used to treat individuals low in urinary citrate, as well as those high in either urinary uric acid or urinary oxalate. Potassium citrate makes the urine more alkaline, thus decreasing the risk for uric acid kidney stones. In addition, potassium citrate is used to treat stones that are caused by hypercitraturia, or excessive level of citrate in the urine.
Sodium Bicarbonate
Italian nephrologist Martino Marangella and colleagues note that sodium bicarbonate is used to treat uric acid kidney stones by making the urine more alkaline. Sodium bicarbonate can be combined with allopurinol.
References
- "Pediatric Nephrology"; Medical Treatment of Pediatric Urolithiasis; Uri S. Alon; November 2009
- "Wisconsin Medical Journal"; Practical Approach to Metabolic Evaluation and Treatment of the Recurrent Stone Patient; Gaurav Bandi, M.D., Stephen Y. Nakada, M.D. and Kristina L. Penniston, PhD, RD; 2008
- "Clinical Cases in Mineral and Bone Metabolism"; Use of Drugs for Nephrolithiasis; Martino Marangella, et al,; May 2008
