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Triamterene nephrolithiasis

B Ettinger, N O Oldroyd, F Sörgel

    JAMA
    |November 28, 1980
    PubMed
    Summary

    Triamterene, a component in some blood pressure medications, was found in 0.4% of kidney stones. Patients with a history of kidney stones should avoid triamterene-containing drugs to prevent triamterene lithiasis.

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    Area of Science:

    • Nephrology
    • Pharmacology
    • Urology

    Background:

    • Triamterene is a potassium-sparing diuretic often combined with hydrochlorothiazide for hypertension management.
    • Renal calculi (kidney stones) are a common clinical problem with multifactorial causes.
    • Drug-induced nephrolithiasis is a recognized but infrequent complication of certain medications.

    Purpose of the Study:

    • To investigate the incidence and characteristics of triamterene deposition in renal calculi.
    • To estimate the risk of triamterene lithiasis in users of triamterene-hydrochlorothiazide.
    • To provide recommendations for preventing triamterene-induced kidney stones.

    Main Methods:

    • Analysis of 50,000 renal calculi submitted for chemical analysis.
    • Identification of triamterene within the calculi composition.
    • Correlation of triamterene presence with medication use and patient history.

    Main Results:

    • Triamterene was identified in 181 renal calculi (0.4% of total).
    • Triamterene was the primary component, a co-deposit with calcium oxalate/uric acid, or the stone's nucleus.
    • A recommended dose of triamterene-hydrochlorothiazide was sufficient to cause triamterene deposition.
    • Estimated annual incidence of triamterene lithiasis is 1 in 1,500 users.
    • Individuals with a prior history of renal stones are at particular risk.

    Conclusions:

    • Triamterene deposition in renal calculi is a complication of triamterene-hydrochlorothiazide therapy.
    • Patients with a history of kidney stones should not be prescribed triamterene-containing medications.
    • Monitoring and awareness are crucial for preventing drug-induced nephrolithiasis.

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