{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T18:48:13Z","timestamp":1781376493979,"version":"3.54.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In this single-center, randomized, placebo-controlled, single-blinded, crossover trial (Clinical Trial Registry-India: CTRI\/2024\/08\/090041), we evaluated the efficacy and safety of low-dose hydrochlorothiazide (HCTZ) in adults with nonsurgical hypoparathyroidism (excluding autoimmune and obvious syndromic forms). After stabilization on fixed doses of calcium carbonate and calcitriol under a controlled low-sodium diet, 26 participants received HCTZ (12.5-25\u00a0mg\/d) or placebo for 7\u00a0d, with a 15-d washout before crossover, followed by an optional 4-wk open-label HCTZ extension. The primary outcome was change in serum calcium; secondary outcomes included change in 24-h urinary calcium (UCa), fractional calcium excretion, urinary sodium, and bone turnover markers (\u03b2-CTX and P1NP). Compared to baseline (8.61\u2009\u00b1\u20090.32\u00a0mg\/dL), serum calcium increased significantly with HCTZ at day 5 (9.01\u2009\u00b1\u20090.46\u00a0mg\/dL) and day 8 (9.04\u2009\u00b1\u20090.52\u00a0mg\/dL; p\u2009&amp;lt;\u2009.001), while no significant change occurred with placebo. Hydrochlorothiazide reduced 24-h UCa by \u221226.3% at day 8 (vs +4.7% with placebo; p\u2009&amp;lt;\u2009.001). These effects remained robust in sensitivity analyses adjusting for urinary sodium and when expressed per kg body weight. Fractional calcium excretion fell by 29.9% with HCTZ (p\u2009&amp;lt;\u2009.001). A small but statistically significant decline in serum potassium was observed at day 8 (from 4.18 to 3.95\u00a0mEq\/L; p\u2009&amp;lt;\u2009.001), though values remained within the normal range, no participants developed hypokalemia; renal function and intact PTH (iPTH) were stable. During the extension phase, serum calcium levels rose while UCa excretion declined significantly, without any reported adverse effects. These findings indicate that low-dose HCTZ with sodium restriction safely improves calcium homeostasis in nonsurgical hypoparathyroidism\u2014raising serum calcium and reducing calciuria\u2014with good tolerability. Hydrochlorothiazide offers a cost-effective adjunct to standard therapy and warrants further investigation for long-term outcomes.<\/jats:p>","DOI":"10.1093\/jbmrpl\/ziaf174","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:10:51Z","timestamp":1762002651000},"source":"Crossref","is-referenced-by-count":2,"title":["Hydrochlorothiazide with salt restriction in nonsurgical hypoparathyroidism: a placebo-controlled single-blinded randomized crossover trial assessing efficacy and safety"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7247-5492","authenticated-orcid":false,"given":"Vivek","family":"Jha","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soham","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1253-1987","authenticated-orcid":false,"given":"Sanjay Kumar","family":"Bhadada","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Sahni","sequence":"additional","affiliation":[{"name":"Department of Dietetics, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sant","family":"Ram","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5415-1611","authenticated-orcid":false,"given":"Pinaki","family":"Dutta","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"2025112411121247100_ref1","first-page":"172","article-title":"Review of hypoparathyroidism","volume":"7","author":"Abate","year":"2016","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"10","key":"2025112411121247100_ref2","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.1002\/jbmr.483","article-title":"Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research","volume":"26","author":"Bilezikian","year":"2011","journal-title":"J Bone Miner Res"},{"issue":"5","key":"2025112411121247100_ref3","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1111\/cen.13395","article-title":"Incidence of parathyroid disorders in Indian adult male population: a 25-year follow-up study","volume":"87","author":"Hari Kumar","year":"2017","journal-title":"Clin Endocrinol"},{"issue":"6","key":"2025112411121247100_ref4","doi-asserted-by":"publisher","first-page":"2284","DOI":"10.1210\/jc.2015-3908","article-title":"Epidemiology and diagnosis of hypoparathyroidism","volume":"101","author":"Clarke","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2025112411121247100_ref5","doi-asserted-by":"publisher","first-page":"106","DOI":"10.20945\/2359-3997000000015","article-title":"Diagnosis and treatment of hypoparathyroidism: a position statement from the Brazilian Society of Endocrinology and Metabolism","volume":"62","author":"Maeda","year":"2018","journal-title":"Arch Endocrinol Metab"},{"issue":"4","key":"2025112411121247100_ref6","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1590\/S0004-27302006000400012","article-title":"Hypoparathyroidism and pseudohypoparathyroidism","volume":"50","author":"Maeda","year":"2006","journal-title":"Arq Bras Endocrinol Metabol"},{"issue":"4","key":"2025112411121247100_ref7","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1056\/NEJMcp0803050","article-title":"Clinical practice. 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