*Serum calcium (>upper limit of normal): 1.0 mg/dL (0.25 mmol/L)

* BMD by DXA: T-score ≤2.5 at lumbar spine, total hip, femoral neck, or distal 1/3 radius; 

*Vertebral fracture by x-ray, CT, MRI             

*Creatinine clearance <60 cc/min;                  24-h urine   for calcium >400 mg/d (>10 mmol/d) and increased stone risk by biochemical stone risk analysis;  

*Presence of nephrolithiasis or nephrocalcinosis by x-ray, ultrasound, or CT

* <50 years