The National Kidney & Urologic Diseases Information Clearinghouse reports that kidney stones are on the rise. While less than 4 percent of Americans had this problem in the late 1970s, more than 5 percent developed kidney stones in the 1990s. While scientists cannot explain the increase, it underscores the importance of preventing this painful condition. If you have had kidney stones once, ask your doctor if HCTZ might help prevent a repeat of the experience.
HCTZ
HCTZ stands for hydrochlorothiazide. Doctors prescribe this drug to lower blood pressure or treat fluid retention caused by congestive heart failure, cirrhosis, kidney disorders and other reasons. It is classified as a diuretic -- a drug that increases the frequency of urination. Some people refer to this type of drug as a "water pill." In addition to these uses, HCTZ can help prevent kidney stones.
Kidney Stones
Kidney stones are tiny bits of solid matter that get wedged in the bladder, urethra or kidney. Doctors classify them according to the material they are made from. Stones made from calcium oxalate are the most common type. Often the stones themselves have jagged, pointy edges that cause intense pain. While they often pass by themselves, sometimes a treatment called extracorporeal shock-wave lithotripsy is used to break up the stones using ultrasound or shock waves.
Treatment
If you get kidney stones once, you are likely to get them again. Preventative efforts include eating a diet low in oxalates. High-oxalate foods include okra, rhubarb, sweet potatoes, peanuts, chocolate, Swiss chard and spinach. Other approaches to prevention include decreasing the amount of calcium in the urine. Unlike calcium-containing diuretics, which increase the likelihood of kidney stones, HCTZ lowers the risk of kidney stones because it decreases urinary calcium. This drug works best when sodium intake is low.
Controversy
Doctors continue to debate the optimal preventative dose of HCTZ. An article in the August 2010 issue of "International Urology and Nephrology" reports that the 1980s saw a shift from prescribing 50 mg HCTZ to 25 mg HCTZ for the treatment of both hypertension and kidney stones. While this shift was appropriate for hypertension, it may not have been appropriate for preventing kidney stones. The authors studied the amount of calcium excretion in patients taking different doses of HCTZ and concluded that a low-dose regimen of HCTZ is ineffective.
References
- National Kidney & Urologic Diseases Information Clearinghouse; Kidney Stones in Adults; October 2007
- "International Urology and Nephrology"; Thiazides Diuretics in the Treatment of Nephrolithiasis: Are We Using Them in an Evidence-Based Fashion?; R. Vigen, et al; August 2010
- PubMed Health: Kidney Stones
