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A 74-year-old female asked:

Will spironolactone lower my sodium number further?it is 128 and i have been removed from hctz due to it.will it harm my kidneys further?i have ckd stage 3,diabetes type 2 and hypertension.i am on insulin,losartan and carvedilol too?

2 doctor answers2 doctors weighed in
Dr. Hiep Le
Dr. Hiep Leanswered
Nephrology and Dialysis 43 years experience
No, it should not. Low blood sodium (hyponatremia) is a well-known side effect of hctz especially if you have a habit or you were advised of increased fluid intake. However, your doctor should check potassium (K) with this combination in 2 weeks because K will likely go up with this combination in patient with CKD. If K is mildly high, you only need to lower K intake, no need to stop new diuretic.
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Dr. Donald Colantino
Internal Medicine 62 years experience
Like Dr. Le, I'm concerned about the combination or spironolactone,losartan ( both retain potassium) especially in a patient with CKD. I'd rather stay on HCTZ. High serum potassium is more dangerous than a sodium of 128 as long as you tolerate it & I recommend checking your potassium after a couple of days if you're taking spironolactone instead of HCTZ.
Created for people with ongoing healthcare needs but benefits everyone.
Last updated May 26, 2022


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