Rapid Recovery of Bone Mass in Hypercalciuric, Osteoporotic Men Treated with Hydrochlorothiazide

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.