Drug Effective for Kidney Stones in Resistant Patients

But acetazolamide is poorly tolerated in many patients

WEDNESDAY, Aug. 20 (HealthDay News) -- Acetazolamide is effective in treating kidney stones in patients who do not respond to potassium citrate and can tolerate the treatment, researchers report in the August issue of Urology.

Samuel P. Sterrett, from the University of Wisconsin-Madison, and colleagues retrospectively reviewed the medical records of 10 compliant patients with uric acid or cystine stones who received acetazolamide to promote urinary alkalization in patients resistant to potassium citrate treatment.

After a mean follow-up of 46.1 months, the researchers found that half of the patients had adverse effects and discontinued treatment. Of the remaining patients, three (60 percent) remained stone-free and two (40 percent) continued to form stones and required surgery, the authors report. The mean urinary pH rose significantly from a mean of 5.9 to 7.2 after treatment, they note.

"Acetazolamide was effective in increasing the urinary pH in patients with uric acid and cystine stone formation who were already taking potassium citrate," Sterrett and colleagues conclude. "Caution must be taken when prescribing acetazolamide, because it could be poorly tolerated and can induce calcium phosphate stone formation."

Two of the study authors report financial relationships with Boston Scientific, Terumo Corporation, and Cook Urological, Inc.

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