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Stones: Diet and Pharmacologic Management: Difference between revisions

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**'''Patients placed on thiazide diuretics for management of hypercalciuria should also be placed on dietary sodium restriction'''
**'''Patients placed on thiazide diuretics for management of hypercalciuria should also be placed on dietary sodium restriction'''
***'''An excess sodium load will inhibit reabsorption of calcium in the proximal tubule, thereby causing hypercalciuria.'''
***'''An excess sodium load will inhibit reabsorption of calcium in the proximal tubule, thereby causing hypercalciuria.'''
*'''Adverse events'''
*'''<span style="color:#ff0000">Adverse events'''
**'''Lassitude and sleepiness'''
**'''<span style="color:#ff0000">Lassitude and sleepiness'''
***'''Most common side effects of thiazides'''
***'''Most common side effects of thiazides'''
***Can occur in the absence of hypokalemia
***Can occur in the absence of hypokalemia
***Usually seen on initiation of treatment but resolves with continued therapy.
***Usually seen on initiation of treatment but resolves with continued therapy.
**'''Metabolic/electrolyte abnormalities''' ('''3 hypers, 3 hypos + metabolic alkalosis''')
**'''<span style="color:#ff0000">Metabolic/electrolyte abnormalities''' ('''3 hypers, 3 hypos + metabolic alkalosis''')
**#'''Hyperglycemia'''
**#'''<span style="color:#ff0000">Hyperglycemia'''
**#'''Hyperlipidemia'''
**#'''<span style="color:#ff0000">Hyperlipidemia'''
**#'''Hyperuricemia'''
**#'''<span style="color:#ff0000">Hyperuricemia'''
**#'''Hypokalemia'''
**#'''<span style="color:#ff0000">Hypokalemia'''
**#'''Hypomagnesemia'''
**#'''<span style="color:#ff0000">Hypomagnesemia'''
**#'''Hypocitraturia'''
**#'''<span style="color:#ff0000">Hypocitraturia'''
**#'''Metabolic alkalosis'''
**#'''<span style="color:#ff0000">Metabolic alkalosis'''
**'''Hypocitraturia'''
**'''Hypocitraturia'''
***'''Result of hypokalemia with intracellular acidosis'''
***'''Result of hypokalemia with intracellular acidosis'''
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**'''Patient's treated with sodium alkali will occasionally begin forming calcium oxalate stones due to an excess sodium load that will inhibit reabsorption of calcium in the proximal tubule, thereby causing hypercalciuria'''
**'''Patient's treated with sodium alkali will occasionally begin forming calcium oxalate stones due to an excess sodium load that will inhibit reabsorption of calcium in the proximal tubule, thereby causing hypercalciuria'''
**'''If the patient is at risk for hyperkalemia, other agents such as sodium bicarbonate or sodium citrate should be considered.'''
**'''If the patient is at risk for hyperkalemia, other agents such as sodium bicarbonate or sodium citrate should be considered.'''
===Recurrent calcium stones===
===Recurrent calcium stones===
*'''<span style="color:#ff0000">Allopurinol should be offered to patients with recurrent calcium oxalate stones who have hyperuricosuria and normal urinary calcium</span>'''
*'''<span style="color:#ff0000">Allopurinol should be offered to patients with recurrent calcium oxalate stones who have hyperuricosuria and normal urinary calcium</span>'''
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