Low-Dose Indapamide vs. Hydrochlorothiazide in Idiopathic Hypercalciuria: A Randomized Prospective Trial

Area of Science:

• Nephrology
• Endocrinology
• Pharmacology

Background:

• Idiopathic hypercalciuria (IH) is a common genetic metabolic disorder linked to urinary stones.
• Thiazide-type diuretics are standard treatment, but low-dose indapamide vs. hydrochlorothiazide data is limited.
• This study compares the safety, efficacy, and adherence of these diuretics in IH patients.

Purpose of the Study:

• To compare the safety and efficacy of low-dose indapamide versus hydrochlorothiazide in patients with idiopathic hypercalciuria.
• To evaluate therapeutic adherence and adverse events associated with each treatment.
• To assess biochemical parameters and kidney stone recurrence rates.

Main Methods:

• A randomized prospective trial involving 101 patients with IH.
• Patients received either indapamide 1.5 mg/day or hydrochlorothiazide 25 mg/day for 18 months.
• Evaluated adverse events, biochemical markers (calciuria, urate, bone turnover), and adherence.

Main Results:

• Both treatments normalized calciuria in over 85% of patients.
• Indapamide significantly reduced β-crosslaps, indicating potential bone protection.
• No significant differences in kidney stone recurrence; indapamide had more mild adverse events, hydrochlorothiazide caused moderate hypokalemia.

Conclusions:

• Low-dose indapamide and hydrochlorothiazide demonstrate comparable efficacy and safety for IH treatment.
• Further long-term studies are required to definitively assess kidney stone recurrence.
• This study provides crucial comparative data on these diuretics for IH management.