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Doctor insights on: Why Do Thiazide Diuretics Cause Hyponatremia

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I may need diuretic, but hctz (hydrochlorothiazide) and metoalzone both caused hyponatremia, 125. What are available options if diuretic is needed in future?

I may need diuretic, but hctz (hydrochlorothiazide) and metoalzone both caused hyponatremia, 125.  What are available options if diuretic is needed in future?

Diuretics: If you take a diuretic (d) one of the side effects is a low sodium level, hyponatremia (h). You can try to avoid h by weighing yourself daily in the morning, at the same time, in your bed clothes and recording the date and your weight. If you lose more than 2 lbs., hold the d for just 1 day. Too rapid weight loss, i.e. > 2 lbs/day can lead to h. If h is a problem, discuss it with your physician. ...Read more

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Diuretic (Definition)

By strict definition, a diuretic is any medicine causing increased urination. More practically, a diuretic is a medicine causing the kidney to secrete excess fluid by blocking the re-absorption of either water itself or electrolytes like sodium (primarily), potassium, chloride and bicarbonate (sodium bicarbonate). These medicines are effective treatments for many disorders including ...Read more


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How come thiazides are called low ceiling diuretics?

Low ceiling: Who calls thiazides 'low ceiling' diuretics. This is a new term for me. Why not ask whoever gave you that terminology. ...Read more

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How do thiazides reduce calcium excretion through urine? And how do loop diuretics increase the excretion of calcium through urine?

How do thiazides reduce calcium excretion through urine? And how do loop diuretics increase the excretion of calcium through urine?

you're right: They do exactly what you said: thiazides reduce urinary calcium excretion and are good for stone formers; loop diuretics increase it and are good for people with hyperparathyroidism and hypercalcemia. The mechanism is complicated. Unless you're taking an exam, this is sufficient information. ...Read more

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Why are thiazide diuretics used in diabetes insipidus?

Why are thiazide diuretics used in diabetes insipidus?

Paradox: Thiazides paradoxically reduce the amount of urine the kidneys produce in the nephrogenic form of di. Thiazides are not used in the central form. ...Read more

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Why thiazides diuretics contraindication with impaired renal failure ?

Why thiazides diuretics contraindication with impaired renal failure ?

Thiazides in CKD: Thiazides are not contraindicated in renal failure for any medical reason. They are not used as they are ineffective of making patients urinate. Patients with chronic kidney disease are placed on loop diuretics which are able to evoke a diuretic response in patients with it. Patients on dialysis are given these drugs when they still have residual renal function so they can eliminate urine. ...Read more

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Resubmit #: is there a thiazide diuretic medication(s) that does not raise glucose levels?

Resubmit #: is there a thiazide diuretic medication(s) that does not raise glucose levels?

Glucose: We keep learning that more of our meds cause some elevation of glucose. I am unaware of any members of the thiazides family that don't cause this. The long term importance of this effect is not certain. ...Read more

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Which of the diuretics (thiazide, loop, potassium sparing) if you were to choose just one may be the best overall to treat hbp?

Which of the diuretics (thiazide, loop, potassium sparing) if you were to choose just one may be the best overall to treat hbp?

Depends: On multiple issues including kidney function. Certain diuretics work better with certain levels of kidney function/dysfunction. In general a thiazide is preferred as first line and particularly Chlorthalidone as it is long acting and potent. See your doctor for specifics as kidney function and potassium levels need to be followed. ...Read more

Dr. Krishna Kumar
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Hyponatremia (Definition)

Normal sodium range from 135 to 145. Low sodium (hyponatremia) is less than 135. Some may have no symptoms at slight decrease in sodium level especially if the level dropped slowly. Rapid decrease or large drop in levels can cause confusion, seizures, coma and even death. Labs should always be rechecked to ...Read more