title: Hydrochlorothiazide in intensive care unit-acquired hypernatremia: A randomized controlled trial.
abstract: Thiazides are suggested as a treatment for intensive care unit (ICU)-acquired hypernatremia (IAH). The primary aim of the study was reducing serum sodium concentration (sNa) in patients with IAH with hydrochlorothiazide (HCT) in comparison to placebo. Secondary end points were a difference in urine sodium concentration (uNa) and duration of severe IAH.
  
  
  
  A monocentric, double-blind, placebo-controlled trial was conducted in 50 patients with IAH and urine potassium + uNa less than sNa in a spot urine sample. Patients were randomized to HCT 25 mg or placebo 1 qd for maximal 7 days. Patients on renal replacement therapy, on medication inducing diabetes insipidus, or with recent use of diuretics were excluded. IAH was defined as sNa of at least 143 mmol/L.
  
  
  
  At baseline, sNa and uNa were comparable between groups. During the study period, sNa decreased significantly with median 4 mmol/L in both groups, with no significant difference between groups (P=.32). Median uNa increased significantly in both groups (46 [16-86] mmol/L in the HCT-group; 20 [10-66]mmol/L in the placebo group), with no difference between groups (P=.34). Median duration of sNa of at least 145 mmol/L was 3 days in both groups (P=.91).
  
  
  
  HCT 25 mg 1 qd did not significantly affect sNa or uNa in patients with IAH.
authors.affiliation: Department of Intensive Care, Medical Centre Leeuwarden, PO Box 888, 8901 BK Leeuwarden, the Netherlands; Department of Internal Medicine, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands. Electronic address: vanijzendoorn@kpnmail.nl.
authors.forename: Marjolein M C O
authors.initials: MM
authors.lastname: van IJzendoorn
authors.affiliation: Department of Intensive Care, Medical Centre Leeuwarden, PO Box 888, 8901 BK Leeuwarden, the Netherlands. Electronic address: hanneke.buter@znb.nl.
authors.forename: Hanneke
authors.initials: H
authors.lastname: Buter
authors.affiliation: Department of Intensive Care, Medical Centre Leeuwarden, PO Box 888, 8901 BK Leeuwarden, the Netherlands. Electronic address: w.p.kingma@znb.nl.
authors.forename: W Peter
authors.initials: WP
authors.lastname: Kingma
authors.affiliation: Department of Intensive Care, Medical Centre Leeuwarden, PO Box 888, 8901 BK Leeuwarden, the Netherlands. Electronic address: matty.koopmans@znb.nl.
authors.forename: Matty
authors.initials: M
authors.lastname: Koopmans
authors.affiliation: Department of Internal Medicine, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands. Electronic address: g.j.navis@umcg.nl.
authors.forename: Gerjan
authors.initials: G
authors.lastname: Navis
authors.affiliation: Department of Intensive Care, Medical Centre Leeuwarden, PO Box 888, 8901 BK Leeuwarden, the Netherlands. Electronic address: e.boerma@chello.nl.
authors.forename: E Christiaan
authors.initials: EC
authors.lastname: Boerma
mesh_terms: D000368:Aged; D003422:Critical Care; D016638:Critical Illness; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000627:therapeutic use*; D006955:Hypernatremia / Q000097:blood / Q000188:drug therapy*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D049993:Sodium Chloride Symporter Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D049993:Sodium Chloride Symporter Inhibitors; D006852:Hydrochlorothiazide
keywords: Critical care; Electrolytes; Hydrochlorothiazide; Hypernatremia; Sodium; Thiazide diuretics