title: Is there a preferred diuretic class for patients with renal impairment and hypertension?
abstract: It is widely believed that "high-ceiling" loop diuretics are required in patients with renal impairment and that "low-ceiling" thiazides are not sufficiently potent to cause meaningful natriuresis and diuresis. If this statement is true, at what level of renal function do thiazides lose their punch? Another related issue is the enlightened use of diuretic combinations. Use of diuretics in chronic kidney disease and hypertension has been addressed in the many guidelines, but further insight is provided in this installment of the "Controversies" series by two well-known authorities, William Elliott, M.D. Ph.D. and Rajiv Agarwal, M.D.
authors.affiliation: University at Buffalo, Buffalo, NY, USA; University of Toronto, Toronto, Ontario, CA, USA. Electronic address: jizzo@buffalo.edu.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Izzo
authors.affiliation: University at Buffalo, Buffalo, NY, USA; University of Toronto, Toronto, Ontario, CA, USA.
authors.forename: Sheldon W
authors.initials: SW
authors.lastname: Tobe
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004232:Diuretics / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy*; D012964:Sodium / Q000652:urine; D049994:Sodium Potassium Chloride Symporter Inhibitors / Q000627:therapeutic use*; D049971:Thiazides / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D004232:Diuretics; D049994:Sodium Potassium Chloride Symporter Inhibitors; D049971:Thiazides; D012964:Sodium
keywords: Chronic kidney disease; hypertension; loop diuretics; thiazide diuretics