Coe F L, Parks J H, Bushinsky D A, Langman C B, Favus M J
Renal Program, Pritzker School of Medicine, University of Chicago, Illinois.
Kidney Int. 1988 Jun;33(6):1140-6. doi: 10.1038/ki.1988.122.
In seven patients with severe idiopathic hypercalciuria and recurrent calcium oxalate nephrolithiasis, we have determined the effects on mineral balance of chronic treatment with chlorthalidone or trichlormethiazide, drugs that are widely used to lower urine calcium losses and reduce stone recurrence. Each person excreted above 350 mg of calcium daily while untreated, and was studied twice, before and after three to six months of treatment. Compared to pretreatment, the drugs reduced intestinal calcium absorption; but they reduced urine calcium loss even more, so calcium retention increased. Phosphate retention also increased. Serum levels of calcitriol, parathyroid hormone, calcium, phosphate, and magnesium were unchanged. At least in patients of this type, chlorthalidone and trichlormethiazide seem ideal treatments, that lower urine calcium yet increase calcium and phosphate retention. Whether patients with less severe hypercalciuria respond this way is unknown.
在7例患有严重特发性高钙尿症和复发性草酸钙肾结石的患者中，我们确定了用氯噻酮或三氯甲噻嗪进行长期治疗对矿物质平衡的影响，这两种药物被广泛用于降低尿钙流失并减少结石复发。每位患者在未治疗时每日钙排泄量超过350毫克，并在治疗前以及治疗三至六个月后进行了两次研究。与治疗前相比，这些药物减少了肠道对钙的吸收；但它们更显著地减少了尿钙流失，因此钙潴留增加。磷酸盐潴留也增加。血清中骨化三醇、甲状旁腺激素、钙、磷酸盐和镁的水平未发生变化。至少在这类患者中，氯噻酮和三氯甲噻嗪似乎是理想的治疗药物，它们能降低尿钙，同时增加钙和磷酸盐潴留。不太严重的高钙尿症患者是否也有同样的反应尚不清楚。
