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Does hydrochlorothiazide prevent recurrent urinary tract infection in children with idiopathic hypercalciuria?
Parsa Yousefi1, Mohammadreza Firouzifar, Ali Cyrus
1Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran.
Insights
Treating idiopathic hypercalciuria (IHC) with hydrochlorothiazide did not prevent recurrent urinary tract infections (UTIs) in girls. Further research is needed to understand the link between IHC and UTIs.
Area of Science:
- Pediatric Nephrology
- Clinical Research
Background:
- Idiopathic hypercalciuria (IHC) is common in children and linked to kidney stones and urinary tract infections (UTIs).
- Hydrochlorothiazide is known to reduce hypercalciuria.
Purpose of the Study:
- To evaluate the effectiveness of hydrochlorothiazide in preventing recurrent UTIs in girls with IHC.
Main Methods:
- A single-blind randomized clinical trial involving 100 girls aged 1-12 with IHC and recurrent UTIs.
- Participants were divided into two groups: one received general UTI prevention advice, the other received advice plus hydrochlorothiazide (1 mg/kg/day).
- UTI recurrence was monitored in both groups.
Main Results:
- The mean age of participants was 7.28 ± 1.9 years.
- Both groups experienced a 66% incidence of UTI recurrence.
Conclusions:
- The study rejects the hypothesis that treating IHC with hydrochlorothiazide prevents recurrent UTIs.
- The relationship between UTIs and IHC requires further investigation, focusing on confounding factors.
Objective:
Idiopathic hypercalciuria (IHC) has been recognized as a common disorder in childhood, and is a major factor in the formation of renal stones and urinary tract infections (UTIs). Since hydrochlorothiazide ameliorates hypercalciuria, we assessed its efficacy in preventing recurrent UTIs in hypercalciuric girls.
Materials And Methods:
This research was a single blind randomized clinical trial. One hundred 1‒12-year-old girls, who were followed in pediatric nephrology outpatient clinics of two referral hospitals in Markazi Province of Iran, were recruited. All patients had IHC and at least two UTIs in 1 year, without any underlying anatomic or functional abnormality of urinary tract. Patients were randomly divided into two equal groups. One group received instructions regarding general preventive measures for UTI and the other group, in addition to these measures, received 1 mg/kg/day hydrochlorothiazide as morning dose. Then recurrence of UTI in the two groups was evaluated.
Results:
The mean age was 7.28 ± 1.9 years. In both groups, the incidence of UTI recurrence was 66%.
Conclusion:
On the basis of these results, we reject the hypothesis that treating hypercalciuria is beneficial in preventing repeated UTIs. The association between UTIs and IHC needs to be more closely studied and attention to eliminating confounding factors is necessary.
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