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Thiazide therapy in chronic hypoparathyroidism: effects on hypercalciuria and renal function-a systematic review and

Vivek Jha1, Mannuru Venkateswarlu2, Amal Shaharyar1

  • 1Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, 160012, India.

Journal of Endocrinological Investigation
|June 13, 2026
PubMed

Insights

Thiazide diuretics may reduce urinary calcium excretion in chronic hypoparathyroidism, but evidence is limited. Further research is needed to confirm efficacy and long-term renal safety in patients with this condition.

Area of Science:

  • Nephrology
  • Endocrinology

Background:

  • Chronic hypoparathyroidism impairs renal calcium reabsorption, leading to hypercalciuria and increased risk of kidney complications.
  • Thiazide diuretics are often used to manage hypercalciuria, but their effectiveness and safety in this context are not well-established.

Purpose of the Study:

  • To evaluate the effects of thiazide therapy on urinary calcium excretion and renal outcomes in patients with chronic hypoparathyroidism.

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed/MEDLINE, Embase, Scopus, Cochrane CENTRAL).
  • Included studies were randomized and observational trials involving adults with chronic hypoparathyroidism treated with thiazides.
  • Meta-analysis was performed using a random-effects model to synthesize quantitative data.

Main Results:

  • Four studies with 64 participants were included; only two were eligible for quantitative synthesis.
  • Meta-analysis showed no significant reduction in urinary calcium excretion (SMD -0.42), with wide confidence intervals indicating substantial imprecision.
  • Qualitative data suggested a potential reduction, but pooled estimates were inconclusive due to small sample sizes, heterogeneity, and short follow-up. Renal function remained stable.

Conclusions:

  • Current evidence suggests a possible benefit of thiazides in reducing urinary calcium excretion in chronic hypoparathyroidism, but the certainty of this finding is low.
  • Inconclusive quantitative results and limited high-quality data necessitate caution.
  • Larger, prospective studies are required to definitively establish the efficacy and long-term renal safety of thiazide therapy in this patient population.
Abstract

Keywords:
Chronic hypoparathyroidismHypercalciuriaRenal outcomesSystematic review and meta-analysis.Thiazide diureticsUrinary calcium excretion

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