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KHASHAYAR SAKHAEE, MICHAEL J. NICAR, D. CRAIG BRATER, CHARLES Y. C. PAK, Exaggerated Natriuretic and Calciuric Responses to Hydrochlorothiazide in Renal Hypercalciuria but not in Absorptive Hypercalciuria, The Journal of Clinical Endocrinology & Metabolism, Volume 61, Issue 5, 1 November 1985, Pages 825–829, https://doi.org/10.1210/jcem-61-5-825
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Abstract
Patients with hypercalciuria have been reported to have an exaggerated response to hydrochlorothiazide (HCTZ), implying a renal tubular defect in solute reabsorption. To determine whether this disturbance is generalized or unique to a particular pathogenetic type of hypercalciuria, we measured the increments in urinary sodium (Δ Na), calcium (Δ Ca), and magnesium after a 100-mg dose of oral HCTZ in 10 normal subjects and 31 patients with different types of hypercalciuric nephrolithiasis. Eleven patients with renal hypercalciuria had significantly greater Δ Na (P < 0.005) and Δ Ca (P < 0.005) than the normal subjects. Ten patients with absorptive hypercalciuria and 10 patients with fasting hypercalciuria without parathyroid stimulation had Δ Na and Δ Ca indistinguishable from those of normal subjects. In all groups, urinary HCTZ and basal 24-h urinary Na did not differ.
The results suggest that the unique natriuretic and calciuric responses to HCTZ occur only in renal hypercalciuric patients with secondary hyperparathyroidism. The data support a renal tubular defect in renal hypercalciuric in contrast to other diagnostic categories of hypercalciuric nephrolithiasis. {J Clin Endocrinol Metab61: 825, 1985)