Woelfel A, Kaplan R A, Pak C Y
Metabolism. 1977 Feb;26(2):201-5. doi: 10.1016/0026-0495(77)90056-7.
The effect of hydrochlorothiazide on the formation of renal stones was evaluated by quantitative assessment of the propensity of urine to undergo crystallization of calcium oxalate. In seven patients with calcium urolithiasis (three with absorptive hypercalciuria, one with renal hypercalciuria, and three with normocalciuric nephrolithiasis), the urinary activity product ratio and formation product ratio of calcium oxalate were measured both on and off therapy with hydrochlorothiazide (50 mg orally twice a day). The activity product ratio (state of saturation with respect to calcium oxalate) decreased in the majority of cases, primarily as a result of the fall in urinary calcium. The formation product ratio (limit of metastability) increased in all cases; the cause of the increase was not readily apparent. Both changes reduced the propensity of urine to undergo crystallization of calcium oxalate, and therefore may account for the clinical improvement reported during thiazide therapy in nephrolithiasis.
通过对尿液草酸钙结晶倾向的定量评估，来评价氢氯噻嗪对肾结石形成的影响。对7例钙结石病患者（3例吸收性高钙尿症、1例肾性高钙尿症和3例正常血钙性肾结石病），在服用氢氯噻嗪（50mg口服，每日2次）治疗期间及停药后，均测定了草酸钙的尿活性产物比率和形成产物比率。多数情况下，活性产物比率（草酸钙饱和状态）下降，主要是由于尿钙降低所致。所有病例的形成产物比率（亚稳极限）均升高；升高原因尚不明朗。这两种变化均降低了尿液草酸钙结晶的倾向，因此可能解释了噻嗪类药物治疗肾结石期间所报告的临床改善情况。
