A 54-year-old woman with recurrent calcium nephrolithiasis and hypertension (BP 158/92 mmHg, HR 78/min) is started on hydrochlorothiazide. Recent labs show serum creatinine 1.2 mg/dL, 24-hour urine calcium 320 mg/day, and serum calcium 9.8 mg/dL. She denies polyuria. Which of the following additional metabolic changes is most likely to occur as a result of this thiazide therapy?
- A)Decreased urinary calcium excretionGABARITO
- B)Increased serum potassium concentration
- C)Metabolic acidosis
- D)Increased urine osmolality by ADH agonism
- E)Increased urinary calcium excretion
Explicação
Decreased urinary calcium excretion is correct. Thiazide diuretics inhibit the Na Cl cotransporter in the distal convoluted tubule and enhance calcium reabsorption, which can help prevent recurrent calcium stones. They can also cause hypokalemic metabolic alka... Ver explicação completa e trilha adaptativa →