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.