Which condition may be exacerbated by the use of hydrochlorothiazide?

Hydrochlorothiazide is a thiazide diuretic commonly used to manage hypertension and edema. One of the significant side effects of thiazide diuretics is that they can increase serum uric acid levels, which can exacerbate conditions like gout. Gout is a form of arthritis that is characterized by the deposition of uric acid crystals in the joints, leading to pain and inflammation. Since hydrochlorothiazide can lead to hyperuricemia (elevated uric acid levels), its use can precipitate or worsen gout attacks in susceptible individuals.

In contrast, other mentioned conditions do not have this strong association with hydrochlorothiazide. Heart failure may actually improve with diuretic use, diabetes insipidus is typically treated with other medications, and acid reflux is not directly impacted by the mechanism of action of hydrochlorothiazide. Therefore, the correct choice highlights an important consideration in the use of this medication, particularly in patients with a history of gout.