M. H. Koppel, (Associate); J. H. Shinaberger, M.D.; S. G. Massry, M.D.; M. Popovtzer, M.D.; J. W. Coburn, M.D., F.A.C.P.
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Thiazides may decrease urinary calcium, and in primary hyperparathyroidism such drugs may aggravate hypercalcemia, presumably because of reduced renal excretion of calcium. We have observed hypercalcemia during thiazide therapy in three uremic patients with clinically overt secondary hyperparathyroidism; serum calcium levels fell upon cessation of thiazide therapy. To further evaluate this phenomenon, studies were undertaken in 14 uremic patients undergoing maintenance hemodialysis. Hydrochlorothiazide, 200 mg/day, was given orally for 2 to 4 weeks; calcium was measured in predialysis and postdialysis blood samples, obtained twice weekly, before (control period), during, and after thiazide therapy. Serum calcium rose to levels above the
Koppel MH, Shinaberger JH, Massry SG, Popovtzer M, Coburn JW. Hypercalcemic Response to Hydrochlorothiazide in Uremia: Evidence for an Extrarenal Effect on Calcium Metabolism.. Ann Intern Med. 1970;72:803. doi: 10.7326/0003-4819-72-5-803_4
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Published: Ann Intern Med. 1970;72(5):803.
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