DO DIURETICS HAVE ANTIHYPERTENSIVE PROPERTIES INDEPENDENT OF NATRIURESIS

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  • 1 January 1977
    • journal article
    • editorial
    • Vol. 22  (5) , 499-504
Abstract
To ascertain whether diuretics have an antihypertensive effect independent of natriuresis, 12 stable patients on maintenance hemodialysis underwent a crossover evaluation with hydrochlorothiazide, 50 mg daily, metolazone, 5 mg daily or placebo in 4 wk treatment periods for 6 mo. Compliance was assured by pill counts and serum drug concentrations. All patients had daily urine < 100 ml. Pre- and postdialysis blood pressure, body weight, plasma volume and plasma renin activity were monitored. Over the 6 mo. study period there were no statistically significant changes in any parameter related to diuretic therapy. A functioning kidney with the ability to respond to diuretics with a natriuresis is probably necessary for antihypertensive action of diuretics. Direct vascular effects of diuretics to lower peripheral resistance could not be demonstrated in this unique patient population.