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Patients with renal disease resulting in severe renal impairment because HCTZ decreases the glomerular filtration rate and may precipitate azotemia in these patients.
Patients with hepatic disease since minor alterations of fluid and electrolyte balance may precipitate hepatic coma.
Patients with gout or hyperuricemia since thiazide diuretics eg, HCTZ have been reported to reduce the clearance of uric acid.
Patients with history of pancreatitis since thiazide diuretics have been reported to cause pancreatitis.
