Acute Effect of Indapamide on Urine Calcium Excretion in Nephrolithiasis and Human Essential Hypertension

Abstract

The effects of indapamide (2.5 mg once a day) on urinary composition are reported in 20 patients (10 with recurrent calcium nephrolithiasis and 10 with essential hypertension) compared with 20 controls. Indapamide was well absorbed in every patient (mean plasma level at the steady state was 111 ± 41 ng/ml) and its antihypertensive action was more pronounced in hypertensive than in normotensive patients. It lowered calcium excretion in 18/20 patients (mean fall on the 7th day of treatment: 53%) and raised the Mg/Ca ratio in 20/20 patients (mean increase on the 7th day: 167%). The effect on Ca²⁺ and Mg²⁺ excretion was not associated with a strong diuretic effect. During intravenous calcium loading (0.375 mmol/kg body weight) 6 normal subjects after a single oral dose of indapamide excreted less calcium, suggesting a direct renal hypocalciuric action by the drug. Indapamide could represent an alternative drug to thiazide diuretics in diseases with dangerous renal calcium losses, but long-term studies are needed.

Thiazide and thiazide-like diuretics in nephrolithiasis

“…Urinary uric acid and citrate did not differ between groups. The expected, comparable, and significant reduction of urinary calcium excretion observed after the first three months on treatment was in accordance with previous reports in stone formers 19,20 . In the present series, the employed dose of HCTZ (25 mg/d) was lower compared to previous studies which claimed that indapamide 2.5 mg/d corresponds to HCTZ 50 mg/d in terms of control of urinary calcium levels 21,22 .…”

Intensive Blood Pressure Control, Falls, and Fractures in Patients with Type 2 Diabetes: The ACCORD Trial

“…2), and in HYVET, the active treatment group received indapamide, a thiazide-like diuretic that has been shown to have similar effects on calcium excretion as other thiazides. [26][27][28][29][30] However, thiazide diuretic use in the standard BP control group was common and adjustment for thiazide diuretic use during the study had a minimal effect on the observed hazard ratios for fracture. Therefore, it is worth considering whether factors other than the greater thiazide diuretic use in the intensive BP control group could have contributed to the 22 % reduction in the relative rate of fracture.…”

Effects of short and long-term indapamide treatments on urinary calcium excretion in patients with calcium oxalate dihydrate urinary stone disease: A pilot study

“…This treatment resulted in a 52% mean decrease in urinary calcium levels [9], suggesting that this may be an effective treatment for patients with this condition. In a study conducted by Borghi et al [10], 20 patients (10 with recurrent calcium lithiasis and 10 with essential hypertension) were given 2.5 mg/day indapamide and examined for urinary composition. This treatment lowered calcium excretion in all of the patients examined, with a 53% decrease being observed on day 7.…”