title: Effects of low-dose hydrochlorothiazide on urolithiasis and bone metabolism in severely disabled individuals: a pilot study.
abstract: To clarify the effects of hydrochlorothiazide (HCT) on calcium metabolism in subjects with severe motor and intellectual disabilities (SMID), we examined four patients (16-48years old) with a history of urolithiasis and/or bone fracture and increased urinary calcium/creatinine ratio (U-Ca/Cr). U-Ca/Cr, blood markers of bone turnover, and bone-mineral density (BMD) were measured before and after administration of low-dose HCT (0.25-0.5mg/kg/day). Three months after the initiation of HCT, U-Ca/Cr decreased in all patients, but this effect was less evident at 9-18months. Bone-turnover marker of bone-specific alkaline phosphatase also showed a tendency to decrease, but BMD remained unchanged during the follow-up period. In SMID patients, HCT is beneficial for the treatment of hypercalciuria but its effects can be transient in certain cases. HCT may also ameliorate the increase in bone turnover, but its effects on the prevention of bone fractures remain uncertain. Hyponatremia is the most frequent and significant adverse effect of HCT, for which a close observation is mandatory in HCT application for patients with SMID.
authors.affiliation: Department of Child Neurology, National Center Hospital of Neurology and Psychiatry, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8551, Japan.
authors.forename: Chizuru
authors.initials: C
authors.lastname: Ikeda
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Saito
authors.forename: Sayuri
authors.initials: S
authors.lastname: Sukigara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakuma
authors.forename: Kenji
authors.initials: K
authors.lastname: Sugai
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Komaki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sasaki
mesh_terms: D000293:Adolescent; D000328:Adult; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism*; D002118:Calcium / Q000652:urine; D003404:Creatinine / Q000652:urine; D004232:Diuretics / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000494:pharmacology* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019989:Persons with Intellectual Disabilities; D010865:Pilot Projects; D011859:Radiography; D052878:Urolithiasis / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D004232:Diuretics; D006852:Hydrochlorothiazide; D003404:Creatinine; D002118:Calcium