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噻嗪类和噻嗪样利尿剂在肾结石中的应用。

Thiazide and thiazide-like diuretics in nephrolithiasis.

机构信息

Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Nefrologia, São Paulo, Brasil.

Universidade Federal do Rio de Janeiro, Departamento de Nefrologia, Rio de Janeiro, Brasil.

出版信息

J Bras Nefrol. 2021 Jan-Mar;43(1):103-109. doi: 10.1590/2175-8239-JBN-2019-0148.

DOI:10.1590/2175-8239-JBN-2019-0148
PMID:33179717
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8061960/
Abstract

Thiazide and thiazide-like diuretics are widely used for the management of hypercalciuria among stone-forming patients. Although the effects of different thiazides should be relatively similar in terms of prevention of stone recurrence, their potency and side effects may differ. However, there is scarce data concerning the metabolic and bone effects of these agents among recurrent nephrolithiasis patients with hypercalciuria. The aim of this update article was to compare our experience in the use of thiazide and thiazide- like diuretics with that of the current literature, concerning their anticalciuric properties and consequent reduction of recurrent stone formation. Their impact on bone mass and potential side effects were also discussed.

摘要

噻嗪类和噻嗪样利尿剂广泛用于结石形成患者的高钙尿症管理。尽管不同噻嗪类药物在预防结石复发方面的作用应该相对相似,但它们的效力和副作用可能不同。然而,关于这些药物在高钙尿症复发性肾结石患者中的代谢和骨骼影响的数据很少。本文更新的目的是比较我们在噻嗪类和噻嗪样利尿剂使用方面的经验与当前文献,涉及它们的抗钙尿作用及其对复发性结石形成的减少。还讨论了它们对骨量的影响和潜在的副作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/957f/8061960/1e927e70c68b/2175-8239-jbn-2019-0148-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/957f/8061960/1e927e70c68b/2175-8239-jbn-2019-0148-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/957f/8061960/1e927e70c68b/2175-8239-jbn-2019-0148-gf01.jpg

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1
Thiazide and thiazide-like diuretics in nephrolithiasis.噻嗪类和噻嗪样利尿剂在肾结石中的应用。
J Bras Nefrol. 2021 Jan-Mar;43(1):103-109. doi: 10.1590/2175-8239-JBN-2019-0148.
2
Effects of thiazides and new findings on kidney stones and dysglycemic side effects.噻嗪类药物的作用以及新发现对肾结石和糖代谢副作用的影响。
Acta Physiol (Oxf). 2024 Jul;240(7):e14155. doi: 10.1111/apha.14155. Epub 2024 May 3.
3
[Effect of thiazide therapy in the prophylaxis of calcium lithiasis].[噻嗪类疗法在预防钙结石方面的作用]
Arch Esp Urol. 2001 Nov;54(9):1047-54.
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Thiazides for kidney stone recurrence prevention.噻嗪类药物预防肾结石复发。
Curr Opin Nephrol Hypertens. 2024 Jul 1;33(4):427-432. doi: 10.1097/MNH.0000000000000990. Epub 2024 Apr 12.
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Efficacy of standard and low dose hydrochlorothiazide in the recurrence prevention of calcium nephrolithiasis (NOSTONE trial): protocol for a randomized double-blind placebo-controlled trial.标准剂量与低剂量氢氯噻嗪预防草酸钙肾结石复发的疗效(NOSTONE 试验):一项随机、双盲、安慰剂对照试验方案。
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Use of thiazide diuretics for the prevention of recurrent kidney calculi: a systematic review and meta-analysis.噻嗪类利尿剂用于预防复发性肾结石:一项系统评价和荟萃分析。
J Transl Med. 2020 Feb 28;18(1):106. doi: 10.1186/s12967-020-02270-7.

引用本文的文献

1
Brazilian Guidelines on evaluation and clinical management of Nephrolithiasis: Brazilian Society of Nephrology.巴西肾结石评估与临床管理指南:巴西肾脏病学会
J Bras Nefrol. 2025 Apr-Jun;47(2):e20240189. doi: 10.1590/2175-8239-JBN-2024-0189en.
2
Metabolic Alkalemia in Hypercalciuria Stone Formers: Does It Matter?高钙尿症结石形成者中的代谢性碱血症:这有关系吗?
Kidney Blood Press Res. 2024;49(1):987-1002. doi: 10.1159/000540953. Epub 2024 Oct 24.
3
SGLT2 inhibitors and nephrolithiasis risk: a meta-analysis.钠-葡萄糖协同转运蛋白2抑制剂与肾结石风险:一项荟萃分析。

本文引用的文献

1
Association Between the Use of Thiazide Diuretics and the Risk of Skin Cancers: A Meta-Analysis of Observational Studies.噻嗪类利尿剂的使用与皮肤癌风险之间的关联:一项观察性研究的荟萃分析。
J Clin Med Res. 2019 Apr;11(4):247-255. doi: 10.14740/jocmr3744. Epub 2019 Mar 18.
2
Efficacy of standard and low dose hydrochlorothiazide in the recurrence prevention of calcium nephrolithiasis (NOSTONE trial): protocol for a randomized double-blind placebo-controlled trial.标准剂量与低剂量氢氯噻嗪预防草酸钙肾结石复发的疗效(NOSTONE 试验):一项随机、双盲、安慰剂对照试验方案。
BMC Nephrol. 2018 Dec 10;19(1):349. doi: 10.1186/s12882-018-1144-6.
3
Nephrol Dial Transplant. 2025 Apr 1;40(4):671-678. doi: 10.1093/ndt/gfae179.
4
An Update on Drug-Nutrient Interactions and Dental Decay in Older Adults.老年人药物-营养素相互作用与龋齿的最新研究进展。
Nutrients. 2023 Nov 23;15(23):4900. doi: 10.3390/nu15234900.
Thiazide Diuretic Dose and Risk of Kidney Stones in Older Adults: A Retrospective Cohort Study.
噻嗪类利尿剂剂量与老年人肾结石风险:一项回顾性队列研究
Can J Kidney Health Dis. 2018 Jul 15;5:2054358118787480. doi: 10.1177/2054358118787480. eCollection 2018.
4
Photosensitizing antihypertensive drug use and risk of cutaneous squamous cell carcinoma.光敏性降压药物的使用与皮肤鳞状细胞癌风险。
Br J Dermatol. 2018 Nov;179(5):1088-1094. doi: 10.1111/bjd.16713. Epub 2018 Aug 14.
5
Hydrochlorothiazide use and risk of nonmelanoma skin cancer: A nationwide case-control study from Denmark.氢氯噻嗪的使用与非黑色素瘤皮肤癌风险:来自丹麦的全国病例对照研究。
J Am Acad Dermatol. 2018 Apr;78(4):673-681.e9. doi: 10.1016/j.jaad.2017.11.042. Epub 2017 Dec 4.
6
Hydrochlorothiazide use is strongly associated with risk of lip cancer.氢氯噻嗪的使用与唇癌风险密切相关。
J Intern Med. 2017 Oct;282(4):322-331. doi: 10.1111/joim.12629. Epub 2017 Jun 6.
7
Melanoma and Non-Melanoma Skin Cancer Associated with Angiotensin-Converting-Enzyme Inhibitors, Angiotensin-Receptor Blockers and Thiazides: A Matched Cohort Study.血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂和噻嗪类药物与黑色素瘤和非黑色素瘤皮肤癌的关系:一项匹配队列研究
Drug Saf. 2017 Mar;40(3):249-255. doi: 10.1007/s40264-016-0487-9.
8
Idiopathic hypercalciuria and formation of calcium renal stones.特发性高钙尿症与钙肾结石的形成。
Nat Rev Nephrol. 2016 Sep;12(9):519-33. doi: 10.1038/nrneph.2016.101. Epub 2016 Jul 25.
9
Use of antihypertensive drugs and risk of skin cancer.抗高血压药物的使用与皮肤癌风险。
J Eur Acad Dermatol Venereol. 2015 Aug;29(8):1545-54. doi: 10.1111/jdv.12921. Epub 2015 Jan 15.
10
Thiazide diuretic prophylaxis for kidney stones and the risk of diabetes mellitus.噻嗪类利尿剂预防肾结石与糖尿病风险
J Urol. 2014 Dec;192(6):1700-4. doi: 10.1016/j.juro.2014.06.078. Epub 2014 Jun 30.