Hydrochlorothiazide treatment of children with hypercalciuria: effects and side effects.
Urinary excretion of calcium and the changes in serum cholesterol fractions were investigated in 15 children with renal hypercalciuria, following 3-month hydrochlorothiazide (HCT) treatment (daily dose 1 mg/kg). Urinary calcium excretion (expressed as the ratio of calcium to creatinine) reached its lowest value after 2 weeks. It was still below the initial value at the end of the 3rd month of treatment (0.84 +/- 0.06, 0.29 +/- 0.03 and 0.6 +/- 0.09 mmol/mmol, respectively). A significant rise in the total serum cholesterol level (4.64 +/- 0.23 vs. 4.25 +/- 0.18 mmol/l before treatment, P < 0.01) and the low-density lipoprotein (LDL)-cholesterol fraction (2.6 +/- 0.24 vs. 2.31 +/- 0.31 before treatment, P < 0.01) was observed at the end of the 3rd month, while high-density lipoprotein (HDL)-cholesterol was slightly decreased. A significant elevation of the LDL/HDL ratio was also observed (from 1.76 +/- 0.17 to 2.2 +/- 0.17, P < 0.001), indicating an increase in the atherogenic cholesterol fractions. The risks and benefits of the thiazide therapy should be considered before starting long-term treatment of children with hypercalciuria and haematuria or renal stone disease.
Reusz
G S
GS
First Department of Paediatrics, Semmelweis University Medical School, Budapest, Hungary.
Dobos
M
M
Tulassay
T
T
Miltényi
M
M
D000293:Adolescent; D002118:Calcium / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004032:Diet; D005260:Female; D006417:Hematuria / Q000188:drug therapy / Q000652:urine; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D007669:Kidney Calculi / Q000188:drug therapy / Q000652:urine; D008055:Lipids / Q000097:blood; D008297:Male
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D006852:Hydrochlorothiazide; D002784:Cholesterol; D002118:Calcium