Thiazide therapy in chronic hypoparathyroidism: effects on hypercalciuria and renal function-a systematic review and exploratory meta-analysis.
Vivek Jha, Mannuru Venkateswarlu, Amal Shaharyar et al.
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In 30 seconds
This systematic review and exploratory meta-analysis assessed thiazide therapy for hypercalciuria and renal outcomes in adults with chronic hypoparathyroidism. Four studies involving 64 participants were included; two studies (n = 26) contributed to the quantitative synthesis. The pooled estimate did not show a statistically significant reduction in urinary calcium excretion (SMD - 0.42; 95% CI - 4.64 to 3.80) and was highly imprecise. Qualitative findings suggested urinary calcium may decrease, while renal function remained stable across studies. Overall, evidence was limited and did not establish efficacy or long-term renal benefit.
Key findings
- The pooled analysis of two studies (n = 26) found no statistically significant reduction in urinary calcium excretion (SMD - 0.42; 95% CI - 4.64 to 3.80).
- Qualitative evidence, including one randomized crossover trial, suggested thiazides may reduce urinary calcium excretion.
- Renal function remained stable across the included studies.
Why it matters
Hypercalciuria in chronic hypoparathyroidism is associated with renal complications, making its management clinically relevant. This review indicates that thiazides may lower urinary calcium, but the pooled evidence is too imprecise to establish the effect, and stable renal function in small, short studies does not demonstrate long-term renal safety or benefit.
What to keep in mind
Evidence came from only four small studies, with two contributing to meta-analysis; studies were methodologically heterogeneous and follow-up was short. Overall certainty was limited.