Medullary Sponge Kidney Medication

Updated: Aug 11, 2020
  • Author: Amit K Ghosh, MD, DM, FACP, MBA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Medication

Medication Summary

Thiazide therapy, in addition to restriction of animal protein intake, and aggressive diuresis may be helpful in patients with medullary sponge kidney and hypercalciuria.

Patients with medullary sponge kidney who demonstrate risk factors for stone formation (ie, hypocitraturia, hypercalciuria, hyperuricosuria, hyperoxaluria) should be considered for treatment with potassium citrate to prevent stone formation. [10]

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Diuretics

Class Summary

The primary role of thiazide diuretics is to decrease hypercalciuria.

Hydrochlorothiazide (Esidrix, Microzide, HydroDIURIL)

This agent inhibits the reabsorption of sodium in distal tubules, causing increased excretion of sodium and water, as well as of potassium and hydrogen ions. Its use is indicated in patients with medullary sponge kidney with hypercalciuria.

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Urinary Alkalinizing Agents

Class Summary

Patients with medullary sponge kidney who demonstrate risk factors for stone formation (ie, hypocitraturia, hypercalciuria, hyperuricosuria, hyperoxaluria) should be considered for treatment with potassium citrate to prevent stone formation.

Potassium citrate (Urocit K)

Potassium citrate is a potassium-based alkalinizer. The starting dose of potassium citrate is 20 mEq/day and should be adjusted to keep a urinary citrate level of 450 mg/day and a urinary pH level of less than 7.5.

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