氯噻酮和氢氯噻嗪对12小时和24小时尿钙排泄的影响。

IF 5.9 2区 医学 Q1 UROLOGY & NEPHROLOGY
Daniel A Wollin, Hassan Fattah, John R Asplin, David S Goldfarb
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引用次数: 0

摘要

目的:晚饭后尿钙排泄量增加,尿量减少。因此,夜间尿钙浓度较高,可能会增加结石形成的风险。我们考虑夜间服用噻嗪类药物是否比白天服用更能有效预防结石:我们对 7 名服用 25 毫克氯沙坦(CTD)的患者和 10 名服用 25 毫克氢氯噻嗪(HCTZ)的患者进行了 12 小时尿液采集。参与者分别在基线、晨起服药一周后和晚间服药一周后采集尿液,所有患者均重复了自选饮食:结果:无论早上还是晚上用药,氯沙坦酮都能减少尿钙在12小时内的排泄:早上用药能将尿钙从基线值130±70毫克/克Cr降至76±52毫克/克Cr(PC结论:氯沙坦酮是一种长效药物,能减少尿钙的排泄:我们的结论是,长效且更有效的 CTD 是预防结石的首选药物。给药时间似乎并不重要,尽管早晨给药可能更有效地解决晚餐后钙排泄较多的问题。最常用的噻嗪类药物(HCTZ)作用时间较短,经常每天用药一次,但在此剂量下似乎不能减少尿钙排泄。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of Chlorthalidone and Hydrochlorothiazide on 12-Hour vs 24 Hour Urinary Calcium Excretion.

Purpose: Urine calcium excretion (UCa) is greater after dinner and urine volumes are lower. The result is higher urine calcium concentrations, which may confer greater risk of stone formation, at night. We considered whether night-time administration-as compared with daytime administration-of thiazides would be more effective for stone prevention.

Materials and methods: We performed 12-hour urine collections in 7 patients taking 25 mg of chlorthalidone (CTD) and 10 patients taking 25 mg of hydrochlorothiazide (HCTZ). Participants completed urine collections at baseline, again after a week of morning medication administration, and again after a week of evening administration, all on repeated self-selected diets.

Results: CTD reduced UCa for both 12-hour periods whether administered in the morning or in the evening: Morning dosing lowered urine calcium from 130 ± 70 mg/g Cr at baseline to 76 ± 52 mg/g Cr (P < .02); evening dosing lowered it to 87 ± 51 mg/g Cr, which was not significant. On the other hand, HCTZ did not reduce UCa regardless of the time of administration: Mean 24-hour UCa was 124 ± 38 mg/g Cr at baseline and 106 ± 40 mg/g Cr when HCTZ was given in AM and 117 ± 54 mg/g Cr when given in PM.

Conclusions: We conclude that the long-acting and more effective CTD is a preferable agent for stone prevention. Time of administration does not seem to be important, although morning administration may more effectively address higher postdinner calcium excretion. The most commonly used thiazide (HCTZ) is shorter acting, frequently dosed once per day, but does not seem to reduce UCa at this dose.

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来源期刊
Journal of Urology
Journal of Urology 医学-泌尿学与肾脏学
CiteScore
11.50
自引率
7.60%
发文量
3746
审稿时长
2-3 weeks
期刊介绍: The Official Journal of the American Urological Association (AUA), and the most widely read and highly cited journal in the field, The Journal of Urology® brings solid coverage of the clinically relevant content needed to stay at the forefront of the dynamic field of urology. This premier journal presents investigative studies on critical areas of research and practice, survey articles providing short condensations of the best and most important urology literature worldwide, and practice-oriented reports on significant clinical observations.
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