Rapid recovery of bone mass in hypercalciuric, osteoporotic men treated with hydrochlorothiazide

Abstract

Background: Chronic hypercalciuria can contribute to osteoporosis, particularly in men.

Objective: To ascertain the effects of resolution of hypercalciuria on bone mineral density.

Design: Case series.

Setting: Referral service for metabolic bone disease in a tertiary-care teaching hospital.

Patients: Five male patients (42 to 66 years of age) with hypercalciuria and osteoporosis.

Intervention: Hydrochlorothiazide, 25 mg twice daily, for a mean (+/- SD) of 7.8 +/- 3.6 months.

Measurements: Fasting urinary calcium:creatinine ratio, serum calciotropic hormone levels, and bone mineral density before and after hydrochlorothiazide administration.

Results: Hydrochlorothiazide resolved hypercalciuria and increased bone mineral density at a rate of 8% and 3% per year at the spine and hip, respectively.

Conclusions: Hydrochlorothiazide treatment in hypercalciuric and osteoporotic men was associated with a rapid rebound increase in bone mineral density.