Which diuretic is known for causing hypercalcemia as a side effect?

Thiazide diuretics are particularly associated with causing hypercalcemia as a side effect. This effect occurs because thiazides inhibit the sodium-chloride symporter in the distal convoluted tubule of the nephron, which not only increases the excretion of sodium and water but also affects calcium reabsorption. Unlike loop diuretics, which typically lead to hypocalcemia, thiazides enhance calcium reabsorption from the renal tubules, leading to an increase in serum calcium levels.

This characteristic makes thiazides unique among diuretic classes, as they can actually be beneficial for patients who suffer from conditions like osteoporosis or renal calcium wasting, where maintaining higher calcium levels is desirable. Understanding the mechanism behind this side effect allows healthcare providers to make informed decisions on the use of thiazide diuretics, especially in patients with a predisposed risk for elevated calcium levels.