Corresponding author and reprint address: Talia Diker-Cohen, MD PhD, Department of Endocrinology, Diabetes & Metabolism, Rabin Medical Center - Beilinson Hospital, 39 Jabotinski St., Petach Tikva, Israel 4941492. Tel: +972-3-9377182; Fax: +972-3-9377181; E-mail: firstname.lastname@example.org
Received: June 25, 2016
Accepted: December 09, 2016
First Published Online: December 14, 2016
ABSTRACT PDF SUPPL DATA
There is no available targeted therapy for control of hypercalciuria in nonoperable patients with primary hyperparathyroidism (PHPT). Thiazide diuretics are used for idiopathic hypercalciuria but avoided in PHPT to prevent exacerbating hypercalcemia. Nevertheless, several reports suggested that thiazides may be safe in patients with PHPT.
To test the safety and efficacy of thiazides in PHPT.
Retrospective analysis of medical records.
Endocrine clinic at a tertiary hospital.
72 patients (58 female, 14 male) with PHPT treated with thiazides for hypercalciuria or hypertension.
Laboratory data were compared for each patient before and after thiazide administration.
Main Outcome Measures:
Effect of thiazide on urine and serum calcium levels.
Mean patient age was 68.9±9.1 years. Patients were treated with hydrochlorothiazide 12.5-50mg/day for 3.1±2.3 years. Treatment led to a decrease in mean levels of urine calcium (427±174 to 251±114mg/day, p<0.001) and parathyroid hormone (115±57 to 74±36ng/L, p<0.001), with no change in serum calcium level (mean: 10.7±0.4 off-treatment, 10.5±1.2mg/dL on-treatment, p=0.4; maximum: 11.1±0.5 off-treatment, 11±0.5mg/dL on-treatment, p=0.8). Findings were consistent over all doses, with no difference in the extent of reduction in urine calcium level or change in serum calcium level by thiazide dose.
Thiazides may be effective and safe for controlling hypercalciuria in patients with PHPT and may have an advantage in decreasing serum PTH level. Effectiveness can be achieved even at a dose of 12.5mg/day, and safety maintained at doses of up to 50mg/day; however, careful monitoring for hypercalcemia is required.
1Institute of Endocrinology, Diabetes and Metabolism, and
2Statistical Consulting Unit, Rabin Medical Center - Beilinson Hospital, Petach Tikva; and
3Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- See more at: http://press.endocrine.org/doi/abs/10.1210/jc.2016-2481?af=Rsthash.EZcAE44T.dpuf