pearljam59
Forum Guru
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A 40yr old woman has recurrent calcium containing renal calculi. Which of the following strategies is most likely to decrease her risk for forming additional calculi?
A. Administration of thiazide diuretic
B. Alkalinization of urine
C. Ingestion of high-oxalate diet
D. Ingestion of high-protein diet
E. Restriction of fluid intake
Note: I narrowed it down to two but I can't justify either answer with the appropriate pathophysiology. Please Explain Why.
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| Geroo
Forum Guru
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A. Administration of thiazide diuretic
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| baryar
Forum Newbie
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ys,it is thiazide diuretics.i cant figure out the exact mechanism but one side effect of thiazide diuretis is hypercalcemia
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| druas
Forum Elite
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its A..I think its a case of idiopathic hypercalciuria.Thiazides inhibit Nacl reabsorptin in distal tubule and increses calcium excretion.So it is benefical in patients who have tendency to form recurrent renal stones and its action on distal tubule is PTH dependent. .....thats all i know
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| pearljam59
Forum Guru
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Thiazides DECREASE calcium excretion, so your body would RETAIN higher levels of calcium. Why would you give a thiazide to someone who has high levels of calcium? A Loop I can understand but NOT a thiazide...any other thoughts?!?!
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| druas
Forum Elite
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ya i mean dec.ca excretion and so will decrease the ca.load in the tubules
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| skyhigh
Forum Guru
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what would alkalinization of urine do
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| robin082006
Forum Hero
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Thiazide
Although it may increase blood Ca initially but thereafter negative feedback machenism will decrease blood Ca level (decreased PTH, decreased Vit D, decreased intestinal absorption)
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| gabydj
Forum Newbie
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loop diuretics contribute to hypercalciuria - they decrease the tubular reabsorption of calcium. Thiazides are used to LOWER urinary calcium.
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