Alexander, R Todd; McArthur, Eric; Jandoc, Racquel; Welk, Blayne; Fuster, Daniel G.; Garg, Amit X; Quinn, Robert R (2018). Thiazide Diuretic Dose and Risk of Kidney Stones in Older Adults: A Retrospective Cohort Study. Canadian journal of kidney health and disease, 5, p. 2054358118787480. Sage 10.1177/2054358118787480
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Background
Thiazide diuretics are commonly prescribed to prevent kidney stones. However, it is unclear whether higher doses confer greater benefit.
Objective
To determine whether lower doses of thiazide diuretics confer a similar protective effect against kidney stone events as higher doses.
Design
Population-based cohort study.
Setting
Linked health administrative databases in Ontario, Canada.
Patients
Older adults newly prescribed a thiazide diuretic between 2003 and 2014 were separated into 2 groups based on daily dose: low dose (⩽12.5 mg hydrochlorothiazide/chlorthalidone, or ⩽1.25 mg indapamide) or high dose.
Measurements
The primary outcome was time to a kidney stone event, using diagnosis and procedure codes. A secondary outcome was kidney stone surgery.
Methods
An association between thiazide diuretic dose and a kidney stone event was estimated using Cox proportional hazards regression.
Results
A total of 536 of 105 239 patients (0.51%) experienced a kidney stone event. We did not detect a difference in kidney stone risk in the high-dose relative to the low-dose group (adjusted hazard ratio, 1.10; 95% confidence interval, 0.93-1.31). Results were similar when analysis was restricted to the more specific outcome of kidney stone surgery. Neither a history of prior kidney stones nor the type of thiazide diuretic modified the effect of diuretic dose on outcome.
Limitations
Patients were >65 years old and we were unable to adjust for some potential confounders such as dietary factors.
Conclusions
Lower dose thiazide diuretics appear to confer a similar protective effect as higher dose thiazides against the development of kidney stones.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension |
UniBE Contributor: |
Fuster, Daniel Guido |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2054-3581 |
Publisher: |
Sage |
Language: |
English |
Submitter: |
Daniel Guido Fuster |
Date Deposited: |
21 Aug 2018 16:02 |
Last Modified: |
05 Dec 2022 15:17 |
Publisher DOI: |
10.1177/2054358118787480 |
PubMed ID: |
30034815 |
Uncontrolled Keywords: |
dose hydrochlorothiazide kidney stones thiazide diuretics |
BORIS DOI: |
10.7892/boris.119425 |
URI: |
https://boris.unibe.ch/id/eprint/119425 |
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