Use of diuretics for hypertension in patients with reduced renal function: a review of clinical effectiveness, safety, and guidelines
Canadian Agency for Drugs and Technologies in Health
Record ID 32011001154
Authors' recommendations: When using a cut-off of creatinine clearance of less than 30mL/min, there was little evidence of the efficacy and safety of thiazide diuretics in patients with reduced renal function. One study suggested that in individuals with creatinine clearance of less than 40 mL/min, blood pressure lowering with HCTZ was similar to furosemide alone or combination treatment with the two diuretics. The use of either diuretic alone or in combination was associated with a reduction GFR, but the reason for this was not reported in the study. Evidence-based guidelines that included recommendations about diuretic selection in individuals with reduced renal function suggest that thiazide diuretics should not be used in individuals with CLcr of less than 30mL/min or who have serum creatinine above 200 mcmol/L, and state that loop diuretics could be used. The limited evidence identified may be a consideration for decisions about use of thiazide diuretics in patients with reduced renal function.
Project Status: Completed
URL for project: http://www.cadth.ca/media/pdf/l0201_diuretics_patients_reduced_renal_function_htis-2.pdf
Year Published: 2010
English language abstract: An English language summary is available
Publication Type: Not Assigned
Organisation Name: Canadian Agency for Drugs and Technologies in Health
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Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)
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