Randomized Prospective Study of a Nonthiazide Diuretic, Indapamide, in Preventing Calcium Stone Recurrences
Randomized Prospective Study of a Nonthiazide Diuretic, Indapamide, in Preventing Calcium Stone Recurrences
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非噻嗪类利尿剂吲达帕胺预防钙结石复发的随机前瞻性研究
DOI：
10.1097/00005344-199306226-00014
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发表时间：
1993
影响因子：
3
通讯作者：
A. Novarini
中科院分区：
文献类型：
--
作者：
L. Borghi;T. Meschi;A. Guerra;A. Novarini
我们研究了生化变化和吲达帕胺在预防钙结石复发中的疗效。将75例钙性肾结石合并高钙尿症患者随机分为3组：饮食加液体（A组），饮食加液体加吲达帕胺2.5 mg/d（B组）。C组：饮食补液+吲达帕胺2.5mg/d+别嘌呤醇300 mg/d。在治疗前和治疗6、12、24和36个月后，我们评估了血压、血清和尿液风险参数（包括草酸钙的相对过饱和度）。磷酸钙和尿酸）、结石率和无钙患者的比例。在治疗的3年中，B和C组的尿钙显著降低。降至治疗前的50%：尿草酸在B组（-24%）和C组（-27%）也显著下降。在B和C组中，草酸钙和磷酸钙的相对过饱和度降低的程度相同（约为治疗前值的一半），C组中尿酸的相对过饱和度降低尤其明显（治疗前值的-65%）。三组结石率均有所改善（P > 0.005）。但对无钙患者进行精算分析，发现吲达帕胺组和吲达帕胺加别嘌呤醇组的疗效明显优于饮食和液体治疗（P > 0.02），而两种药物组之间无任何差异。由于吲达帕胺的副作用比噻嗪类利尿剂少，我们得出结论，吲达帕胺可能是一个有趣的替代噻嗪类药物在预防高钙尿患者的钙结石。
We examined the biochemical changes and the efficacy of indapamide in the prevention of calcium stone recurrences. Seventy-five patients with calcium nephrolithiasis and hypercalciuria were randomly assigned to three different therapies: diet and fluid (group A), diet and fluid plus indapamide 2.5 mg/day (group B). and diet and fluid plus indapamide 2.5 mg/day plus allopurinol 300 mg/day (group C). Before treatment and after 6, 12, 24, and 36 months of therapy, we evaluated blood pressure, serum and urine risk parameters (including relative supersaturations of calcium oxalate. calcium phosphate and uric acid), stone rate, and the proportion of calculi-free patients. During the 3 years of treatment, urinary calcium greatly decreased in groups B and C. dropping to 50% of the pretreatment values: urinary oxalate also significantly declined in group B (- 24%) and group C (-27%). Relative supersaturations of calcium oxalate and calcium phosphate decreased to the same extent in groups B and C (about one-half of the pretreatment value), and relative supersaturation of uric acid was particularly reduced in group C (-65% of the pretreatment value). The stone rate improved in all three groups (p > 0.005). but using actuarial analysis in the evaluation of calculi-free patients, indapamide, and indapamide plus allopurinol groups were found to have a significantly more favorable effect than diet and fluid treatment (p > 0.02), without any difference between the two drug groups. Because indapamide has fewer side effects than thiazide diuretics, we conclude that indapamide could be an interesting alternative to thiazides in the prevention of calcium stones in hypercalciuric patients.