Chlorthalidone Is Superior to Potassium Citrate in Reducing Calcium Phosphate Stones and Increasing Bone Quality in Hypercalciuric Stone-Forming Rats
| Autor: | Marc D. Grynpas, Nancy Krieger, David A. Bushinsky, Courtney Flotteron, Ignacio Granja, John R. Asplin, Tong Tong Wu, Luojing Chen, Felix M. Ramos |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Bone mineral medicine.medical_specialty Potassium 030232 urology & nephrology chemistry.chemical_element General Medicine Urine Calcium Phosphate medicine.disease 03 medical and health sciences chemistry.chemical_compound 030104 developmental biology 0302 clinical medicine Endocrinology chemistry Nephrology Internal medicine medicine Chlorthalidone Hypercalciuria Kidney stones medicine.drug |
| Zdroj: | Journal of the American Society of Nephrology. 30:1163-1173 |
| ISSN: | 1533-3450 1046-6673 |
| DOI: | 10.1681/asn.2018101066 |
| Popis: | Background The pathophysiology of genetic hypercalciuric stone-forming rats parallels that of human idiopathic hypercalciuria. In this model, all animals form calcium phosphate stones. We previously found that chlorthalidone, but not potassium citrate, decreased stone formation in these rats. Methods To test whether chlorthalidone and potassium citrate combined would reduce calcium phosphate stone formation more than either medication alone, four groups of rats were fed a fixed amount of a normal calcium and phosphorus diet, supplemented with potassium chloride (as control), potassium citrate, chlorthalidone (with potassium chloride to equalize potassium intake), or potassium citrate plus chlorthalidone. We measured urine every 6 weeks and assessed stone formation and bone quality at 18 weeks. Results Potassium citrate reduced urine calcium compared with controls, chlorthalidone reduced it further, and potassium citrate plus chlorthalidone reduced it even more. Chlorthalidone increased urine citrate and potassium citrate increased it even more; the combination did not increase it further. Potassium citrate, alone or with chlorthalidone, increased urine calcium phosphate supersaturation, but chlorthalidone did not. All control rats formed stones. Potassium citrate did not alter stone formation. No stones formed with chlorthalidone, and rats given potassium citrate plus chlorthalidone had some stones but fewer than controls. Rats given chlorthalidone with or without potassium citrate had higher bone mineral density and better mechanical properties than controls, whereas those given potassium citrate did not. Conclusions In genetic hypercalciuric stone-forming rats, chlorthalidone is superior to potassium citrate alone or combined with chlorthalidone in reducing calcium phosphate stone formation and improving bone quality. |
| Databáze: | OpenAIRE |
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