Risk of Hyponatremia associated with use of Thiazide Diuretics higher than anticipated

Written By : Jacinthlyn Sylvia |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-12-26T20:30:28+05:30 | Updated On 27 Dec 2023 11:41 AM IST

A recent study by Niklas Worm Andersson and team found that the treatment initiation with thiazide diuretics increases the potential risk for hyponatremia, particularly during the initial months of treatment. Based on a population and register-based cohort, the findings were published in the Annals of Internal Medicine.

Thiazide-induced hyponatremia is a condition characterized by low levels of sodium. This is an elusive concern as the existing drug labels suggest it to be rare, occurring at rate less than 1 in 10,000.

This study was conducted in Denmark from January 2014 to October 2018 which aimed to estimate the cumulative incidence of hyponatremia. The research focused on individuals aged 40 years or older with no recent prescription for antihypertensive drugs and no previous hyponatremia. Th research team compared the new use of bendroflumethiazide (BFZ) with a calcium-channel blocker (CCB) and the new use of hydrochlorothiazide plus a renin–angiotensin system inhibitor (HCTZ–RASi) with RASi alone.

Among the 37,786 BFZ users, the outcomes of this study highlighted that the 2-year cumulative incidence of hyponatremia was 3.83% when compared to 3.51% for HCTZ–RASi. The risk differences of 1.35% was found between BFZ and CCB and 1.38% between HCTZ–RASi and RASi respectively. Also, the hazard ratios of the BFZ was 3.56 and HCTZ–RASi was 4.25 in the first 30 days. The study highlighted the outcome of increased substantial risk during the initial months of diuretics treatment.

The implications of the study challenges the existing understanding of the safety profile of thiazide diuretics specially regarding hyponatremia. The excess risk identified were particularly in the early stages of treatment that calls for a reevaluation of prescribing practices and heightened awareness among healthcare providers.

Source:

Andersson, N. W., Wohlfahrt, J., Feenstra, B., Hviid, A., Melbye, M., & Lund, M. (2023). Cumulative Incidence of Thiazide-Induced Hyponatremia. In Annals of Internal Medicine. American College of Physicians. https://doi.org/10.7326/m23-1989

Annals of Internal MedicineThiazide-induced hyponatremiaDiuretics use

Source : Annals of Internal Medicine

Jacinthlyn Sylvia

Neuroscience Masters graduate

Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751