Short term effect of withdrawal of diuretic drugs prescribed for ankle oedema.
OBJECTIVE
To determine the effect of withdrawing diuretic drugs on oedema in patients prescribed them for only ankle oedema, excluding patients with cardiac, hepatic, or renal failure.


METHODS
Randomised controlled trial.


METHODS
15 general practices in the Netherlands.


METHODS
1202 patients aged 65 years or older and taking diuretic drugs, 63 of whom were eligible for the trial.


METHODS
Change in volumetrically determined ankle oedema (oedema index) over six weeks.


RESULTS
34 patients were randomised to stop diuretics and 29 to the control group. In eight patients diuretics had to be restarted. Among patients who had diuretics withdrawn successfully, rebound oedema caused a temporary increase in mean oedema index. The peak level (3.5% (95% confidence interval 1.5% to 5.2%) was reached in the third week, after which the oedema seemed to be returning to the baseline level.


CONCLUSIONS
Few patients who have been prescribed diuretics for only ankle oedema clearly have no contraindications to withdrawing diuretics. If patients are unlikely to have cardiac insufficiency and careful monitoring is provided, withdrawal of diuretics seems to be feasible, though moderate rebound oedema may occur for a short time.
de Jonge
J W
JW
University of Limburg, Maastricht, Netherlands.
Knottnerus
J A
JA
van Zutphen
W M
WM
de Bruijne
G A
GA
Struijker Boudier
H A
HA
D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint; D004232:Diuretics / Q000009:adverse effects* / Q000627:therapeutic use; D004487:Edema / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000188:drug therapy*; D008297:Male; D010349:Patient Compliance; D013375:Substance Withdrawal Syndrome
D004232:Diuretics