Is there a preferred diuretic class for patients with renal impairment and hypertension?

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• 作者：Joseph L. Izzo Jr. ; MD^a ; ^b ; ^{jizzo@buffalo.edu" class="auth_mail" title="E-mail the corresponding author} ; Sheldon W. Tobe ; MD^a ; ^b
• 关键词：Chronic kidney disease ; hypertension ; loop diuretics ; thiazide diuretics
• 刊名：Journal of the American Society of Hypertension
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：10
• 期：4
• 页码：282-284
• 全文大小：85 K

文摘

It is widely believed that “high-ceiling” loop diuretics are required in patients with renal impairment and that “low-ceiling” thiazides are not sufficiently potent to cause meaningful natriuresis and diuresis. If this statement is true, at what level of renal function do thiazides lose their punch? Another related issue is the enlightened use of diuretic combinations. Use of diuretics in chronic kidney disease and hypertension has been addressed in the many guidelines, but further insight is provided in this installment of the “Controversies” series by two well-known authorities, William Elliott, M.D. Ph.D. and Rajiv Agarwal, M.D.