A 39-year-old woman presents with recurrent calcium oxalate kidney stones despite increased fluid intake and compliance with dietary modifications. Vital signs are stable (BP 128/82, HR 78, RR 14, Temp 37°C). Laboratory studies reveal hypercalciuria on 24-hour urine collection (320 mg/day; normal <250 mg/day) with normal serum calcium and intact parathyroid hormone levels. Serum creatinine is 0.9 mg/dL. She denies polyuria or polydipsia. Which medication most likely reduces future stone formation?
- A)Mannitol
- B)Spironolactone
- C)HydrochlorothiazideGABARITO
- D)Furosemide
- E)Acetazolamide
Explicação
Thiazide diuretics increase calcium reabsorption in the distal convoluted tubule and can reduce urinary calcium excretion, which helps prevent recurrent calcium stones. This is a classic therapeutic use of thiazides beyond blood pressure control. Ver explicação completa e trilha adaptativa →