The Evidence-Based Use of Thiazide Diuretics in Hypertension and Nephrolithiasis

Thiazide-type diuretics are commonly used in the treatment of hypertension and nephrolithiasis. Evidence from randomized clinical trials needs to be considered in decisions about agent choice and dose. In nephrolithiasis, one of the major limitations of the literature is a paucity of data on the dos...

Full description

Saved in:
Bibliographic Details
Published in:Clinical journal of the American Society of Nephrology 2010-10, Vol.5 (10), p.1893-1903
Main Authors: Reilly, Robert F, Peixoto, Aldo J, Desir, Gary V
Format: Article
Language:English
Subjects:
Antihypertensive Agents - adverse effects
Antihypertensive Agents - therapeutic use
Blood Pressure - drug effects
Drug Therapy, Combination
Evidence-Based Medicine
Humans
Hypertension - drug therapy
Hypertension - physiopathology
Nephrolithiasis - drug therapy
Secondary Prevention
Sodium Chloride Symporter Inhibitors - adverse effects
Sodium Chloride Symporter Inhibitors - therapeutic use
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Thiazide-type diuretics are commonly used in the treatment of hypertension and nephrolithiasis. Evidence from randomized clinical trials needs to be considered in decisions about agent choice and dose. In nephrolithiasis, one of the major limitations of the literature is a paucity of data on the dose-response effect of hydrochlorothiazide (HCTZ) on urinary calcium excretion. The best available evidence for prevention of stone recurrence suggests the use of indapamide at 2.5 mg/d, chlorthalidone at 25 to 50 mg daily, or HCTZ 25 mg twice a day or 50 mg daily. In hypertension, chlorthalidone (12.5 to 30 mg daily) may be the best choice when a diuretic is used for initial therapy, with indapamide (1.5 mg daily) being a valuable alternative for older patients. When adding a thiazide to other drug classes, indapamide (2.5 mg daily) has demonstrated value in hypertensive patients who have had a stroke, and HCTZ (12.5 to 25 mg daily) has a safe track record in several patient groups. Although chlorthalidone has not been tested as add-on therapy, the authors believe it is a safe option in such cases.
ISSN:1555-9041
1555-905X
DOI:10.2215/CJN.04670510