title: Low-dose thiazide diuretics in children with idiopathic renal hypercalciuria.
abstract: OBJECTIVE
  To evaluate the therapeutic effect of hydrochlorothiazide in idiopathic renal hypercalciuria.
  
  
  METHODS
  We retrospectively analysed the data of 28 children (6.0±4.1 years, M:F=19:9) diagnosed as having idiopathic renal hypercalciuria from the years 1991 to 2008. The dose of hydrochlorothiazide was initially 0.5 mg/kg/day and gradually increased to achieve the appropriate hypocalciuric effect (urinary calcium/creatinine<0.2 mg/mg) in some unresponsive patients.
  
  
  RESULTS
  Twenty-two patients (79%) had gross haematuria, 6 (21%) microscopic haematuria, 2 left flank pain, 6 (21%) urolithiasis and 9 (32%) urinary tract infection at the diagnosis of hypercalciuria. The low doses (0.5 mg/kg/day) of hydrochlorothiazide reduced urinary calcium excretion in 25 patients (89%) and 3 (11%) required the increased doses (1-2 mg/kg/day). Haematuria and urolithiasis gradually resolved in accordance with the improvement of hypercalciuria. Nineteen patients (68%) maintaining hypocalciuria during hydrochlorothiazide therapy were discontinued after 12.5±5.3 months of treatment. Eleven of the 19 patients maintained normocalciuria, while 8 showed increased urinary calcium excretion at 2.9±2.3 months after treatment was stopped, requiring thiazide retreatment.
  
  
  CONCLUSIONS
  Our results suggest that low dose (0.5 mg/kg/day) of hydrochlorothiazide may be safe and effective in controlling renal hypercalciuria in children.
authors.affiliation: Department of Pediatrics, The Institute of Kidney Disease, Yonsei University College of Medicine, Severance Children's Hospital, Seoul, Korea.
authors.forename: Ji Na
authors.initials: JN
authors.lastname: Choi
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Lee
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Shin
mesh_terms: D002648:Child; D004232:Diuretics / Q000008:administration & dosage*; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage*; D053565:Hypercalciuria / Q000188:drug therapy* / Q000209:etiology; D007674:Kidney Diseases / Q000150:complications / Q000188:drug therapy*; D008297:Male; D049993:Sodium Chloride Symporter Inhibitors / Q000008:administration & dosage*
chemical_list: D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors; D006852:Hydrochlorothiazide