Abstract | OBJECTIVE: To determine whether thiazides have a chronic antihypertensive effect, in the absence of diuresis, in patients with severe renal disease ( creatinine clearance <30 mL/min) or in those receiving dialysis. DATA SOURCES: A search was performed in PubMed, CENTRAL, and International Pharmaceutical Abstracts, using MeSH terms and/or key words. MeSH terms included kidney failure, chronic and exploded terms hydrochlorothiazide, renal dialysis, and thiazides. Key words included thiazide*, hydrochlorothiazide, chlorothiazide, chlorthalidone, indapamide, metolazone, methyclothiazide, bendroflumethiazide, hemodialysis, dialysis, kidney failure, renal failure, renal insufficiency, hypertension, vasodilation, vascular, and diuretics. STUDY SELECTION AND DATA EXTRACTION: All relevant English-language publications were evaluated. Studies evaluating the efficacy of thiazides in renal insufficiency or dialysis were limited to those that included blood pressure measurements. Studies were included only if treatment duration was at least 4 weeks to evaluate chronic antihypertensive effects. DATA SYNTHESIS: CONCLUSIONS:
Thiazide diuretics may decrease peripheral vascular resistance independent of natriuresis. However, because current clinical data are inconclusive as to the efficacy of these agents at chronically lowering blood pressure in patients with severe renal disease or in those on dialysis, thiazide diuretics cannot be routinely recommended for this indication.
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Authors | Cynthia Y Chan, Evan J Peterson, Tien M H Ng |
Journal | The Annals of pharmacotherapy
(Ann Pharmacother)
Vol. 46
Issue 11
Pg. 1554-8
(Nov 2012)
ISSN: 1542-6270 [Electronic] United States |
PMID | 23136355
(Publication Type: Journal Article, Review)
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Chemical References |
- Antihypertensive Agents
- Sodium Chloride Symporter Inhibitors
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Topics |
- Antihypertensive Agents
(administration & dosage)
- Diuresis
- Humans
- Kidney Diseases
(drug therapy)
- Sodium Chloride Symporter Inhibitors
(administration & dosage)
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