Thiazide Diuretics · Pharmacology

A patient with a history of recurrent calcium oxalate kidney stones is started on a thiazide diuretic. What is the therapeutic goal?

  1. To increase the volume of urine significantly
  2. To decrease the urinary concentration of calcium
  3. To alkalinize the urine
  4. To increase the excretion of citrate
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Correct answer: To decrease the urinary concentration of calcium

Thiazides enhance the distal reabsorption of calcium, thereby reducing the amount of calcium present in the urine (hypocalciuria). Lower calcium concentrations reduce the likelihood of stone formation.

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