Thiazide diuretics can help prevent kidney stones, study finds

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A new study from Vanderbilt University Medical Center, using genetic data, provides fresh insights into the effectiveness of thiazide diuretics in preventing kidney stones, challenging recent doubts about their efficacy.

Kidney stones are a common health issue globally, affecting about 10% of people. Thiazide diuretics, traditionally used for high blood pressure, have been a standard treatment for preventing kidney stones for over 30 years.

These medications work by reducing the amount of calcium excreted in urine, which is a key factor in kidney stone formation.

However, recent clinical trials, including the NOSTONE trial published in The New England Journal of Medicine, questioned the effectiveness of thiazide diuretics in kidney stone prevention.

This trial specifically found no protective effect of these diuretics against kidney stone disease, casting doubt on their long-standing use.

The Vanderbilt Study’s Findings

Contradicting these doubts, the Vanderbilt study used genetic markers in over 1 million adults to simulate the long-term effects of thiazide diuretics.

The research, published in JAMA Network Open, found that these genetic proxies were associated with a 15% lower risk of developing kidney stones.

Lead author Jefferson Triozzi, MD, pointed out that the genetic proxies for thiazide diuretics were also linked to higher serum calcium levels. This finding supports the theory that thiazides reduce kidney stone risk by influencing how the body handles calcium.

The Role of the VA Million Veteran Program

A significant portion of the study’s data came from participants in the VA Million Veteran Program (MVP), the largest and most diverse biobank in the world.

This program studies the impacts of genetics, lifestyle, and other factors on veterans’ health. Adriana Hung, MD, MPH, emphasized the MVP’s value in genetically informed drug discovery and repurposing.

Future Research and Implications

The Vanderbilt research team plans to delve deeper into the mechanisms by which thiazide diuretics lower kidney stone risk. Their findings underscore the significance of using genetic proxies to estimate medication effects over the long term.

This study contributes new evidence supporting the use of thiazide diuretics for kidney stone prevention. It highlights the potential of genetic data in understanding drug mechanisms and guiding new drug discoveries, especially for kidney stone disease.

In summary, while recent clinical trials cast doubt on the effectiveness of thiazide diuretics, this latest genetic study offers a renewed perspective, suggesting these medications may still play a crucial role in preventing kidney stones.

If you care about kidney health, please read studies about how to protect your kidneys from diabetes, and drinking coffee could help reduce risk of kidney injury.

For more information about kidney health, please see recent studies about foods that may prevent recurrence of kidney stones, and eating nuts linked to lower risk of chronic kidney disease and death.

The research findings can be found in JAMA Network Open.

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