Hydrochlorothiazide, 200 mg/day, was given orally for 2 to 4 weeks to 14 patients treated with maintenance hemodialysis for end-stage renal disease. Predialysis levels of serum calcium rose in 13 patients, and distinct hypercalcemia developed in 8 patients. Changes in serum levels of diffusible calcium paralleled those of total calcium concentrations. Predialysis levels of serum magnesium also rose during thiazide administration. The infusion of parathyroid extract, 1 unit/hr/kg of body weight for 10 hr, failed to ellcit a normal increase in serum calcium in most of the uremic patients who had a calcemic response to thiazides. These data demonstrate an extrarenal effect of thiazides on calcium and magnesium metabolism. It is proposed that the calcemic effect of thiazides in these patients may be due to potentiation of the action of parathyroid hormone on bone.
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M.H. Koppel (1970) studied this question.
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