
Health Dictionary
Reliable, easy-to-read patient information on common medical conditions β written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Dent's disease medical therapy
Introduction
Overview
Overview
Medical Therapy
Medical Therapy
As of today, there is no agreed-upon treatment of Dent’s disease and no therapy has been formally accepted. Most treatment measures are mostly supportive in nature and they include:
- Thiazide diuretics which have been used with success in reducing the calcium output in urine, but they are also known to cause hypokalemia.
- In rats with diabetes insipidus thiazide diuretics inhibit the NaCl co-transporter in the renal distal convoluted tubule leading indirectly to less water and solutes being delivered to the distal tubule.[1]
- Amiloride which also increases distal tubular calcium reabsorption and has been used as a therapy for idiopathic hypercalciuria.
- A combination of 25 mg of chlorthalidone plus 5 mg of amiloride daily led to a substantial reduction in urine calcium in Dent’s patients, however urine pH was “significantly higher in patients with Dentβs disease than in those with idiopathic hypercalciuria (P < 0.03), and supersaturation for uric acid was consequently lower (P < 0.03).”[2]
- For patients with osteomalacia, Vitamin D or derivatives have been employed, apparently with success.
- Some lab tests on mice with CLC-5 related tubular damage showed that a high citrate diet preserved renal function and delayed progress of renal disease.[3]
References
References
- β Johannes Loffing, JASN, Paradoxical Antidiuretic Effect of Thiazides in Diabetes Insipidus: Another Piece in the Puzzle
- β JASN, Responsiveness of Hypercalciuria to Thiazide in Dentβs Disease
- β Johns Hopkins University School of Medicine, High citrate diet delays progression of renal insufficiency in the ClC-5 knockout mouse model of Dent’s disease
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
