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Thiazide diuretics can increase renal tubular reabsorption of calcium, resulting in hypercalcemia. However, thiazide-associated hypercalcemia also can represent unmasking of preexisting primary hyperparathyroidism (PHPT) or incidental development of PHPT during thiazide therapy. Mayo Clinic researchers used their Olmsted County, Minnesota, database to explore the incidence and features of thiazide-associated hypercalcemia that was identified in 221 patients between 1992 and 2010.
Thiazide-associated hypercalcemia was more common in women than in men (incidence, 20 vs. 4 cases per 100,000 person-years), and incidence increased with age. Hypercalcemia was first noted a median of 4 years after thiazide was started, and mean highest calcium leve…