Kidney Stones - Treatment

Medications

Diuretics. Diuretics are commonly used in the treatment of high blood pressure and other disorders to eliminate fluid and sodium from the body. Low doses of diuretics known as thiazides are sometimes used to reduce the amount of calcium released by the kidneys into the urine. Thiazides include:

• Hydrochlorothiazide (Esidrix, HydroDiuril)
• Chlorothiazide (Diuril)
• Trichlormethiazide (Metahydrin, Naqua)
• Chlorthalidone (Hygroton)

However, thiazides also cause potassium loss, which reduces citrate levels and can increase the risk for stones. Potassium citrate should be taken with a thiazide to prevent citrate loss. Amiloride (Midamor) is a potassium-sparing diuretic, which may be used if a thiazide does not work.

Citrates. Citrate salts are often given to people with calcium oxalate or uric acid stones:

• Potassium magnesium citrate is available over the counter. It is proving to be very beneficial in preventing kidney stones. In one study, potassium magnesium citrate reduced the risk for kidney stone recurrence by 85%.
• Potassium citrate (K-Lyte, Polycitra-K, Urocit-K) is given as the only treatment to people with normal urine calcium levels. Between 70 - 75% of patients with recurrent stones have experienced on-going remission with potassium citrate therapy. Some people cannot tolerate potassium citrate because of side effects (stomach problems).
• Magnesium citrate (Citroma, Citro-Nesia) may be useful for people who develop calcium stones from impaired intestinal absorption due to small bowel disease.

None of these products should be used by people with struvite stones, urinary tract infections, bleeding disorders, or kidney damage. Patients who take citrate supplements containing potassium should not take any other medications that either contain the mineral or prevent its loss (such as so-called potassium-sparing diuretics). People with peptic ulcers should avoid them or discuss using non-tablet forms with their doctor.

Phosphates. Phosphates help reduce the breakdown of bone that releases calcium into the bloodstream. They are also involved in reabsorption of calcium from urine by the kidney.