Which drug class is often prescribed to decrease urinary calcium concentrations to prevent calcium oxalate stones?

Thiazide diuretics are frequently prescribed for patients with hypercalciuria, a condition characterized by elevated calcium levels in the urine, which can lead to the formation of calcium oxalate stones. These medications work by promoting calcium reabsorption in the renal tubules, which reduces the urinary excretion of calcium.

By decreasing urinary calcium concentrations, thiazide diuretics effectively help prevent the precipitation of calcium salts, thus reducing the risk of stone formation. This mechanism is particularly beneficial for patients who are prone to calcium oxalate kidney stones, as it addresses one of the primary contributing factors to stone development.

In contrast, loop diuretics generally increase renal calcium excretion, which could exacerbate the condition. Potassium-sparing diuretics primarily preserve potassium and do not significantly affect calcium levels in the urine in the same way. Carbonic anhydrase inhibitors primarily alter the reabsorption of bicarbonate and are not specifically aimed at decreasing urinary calcium concentrations for the prevention of calcium oxalate stones.