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Hydrochlorothiazide in intensive care unit-acquired hypernatremia: A randomized controlled trial
Marjolein M C O van IJzendoorn1, Hanneke Buter2, W Peter Kingma2
1Department 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.
Journal of Critical Care
|December 17, 2016
Summary
Hydrochlorothiazide (HCT) did not significantly reduce serum sodium in intensive care unit-acquired hypernatremia (IAH) patients. The study found no significant difference in serum sodium or urine sodium levels between HCT and placebo groups.
Area of Science:
- Nephrology
- Critical Care Medicine
- Clinical Pharmacology
Background:
- Intensive care unit-acquired hypernatremia (IAH) is a common electrolyte imbalance.
- Thiazides, such as hydrochlorothiazide (HCT), are considered a potential treatment for IAH.
- Evidence supporting the efficacy of HCT in IAH is limited.
Purpose of the Study:
- To evaluate the efficacy of hydrochlorothiazide (HCT) in reducing serum sodium concentration (sNa) in patients with IAH.
- To compare the effects of HCT versus placebo on urine sodium concentration (uNa) and the duration of severe IAH.
Main Methods:
- A monocentric, double-blind, placebo-controlled trial involving 50 IAH patients.
- Patients received either HCT 25 mg or placebo once daily for up to 7 days.
- Exclusion criteria included renal replacement therapy, medications inducing diabetes insipidus, or recent diuretic use.
Main Results:
- Serum sodium (sNa) decreased by a median of 4 mmol/L in both HCT and placebo groups, with no significant difference between them (P=.32).
- Urine sodium (uNa) increased significantly in both groups, but without a significant difference between HCT and placebo (P=.34).
- The median duration of severe IAH (sNa ≥ 145 mmol/L) was 3 days for both groups (P=.91).
Conclusions:
- Hydrochlorothiazide (HCT) at 25 mg once daily did not significantly alter serum sodium or urine sodium levels in patients with IAH.
- The findings suggest HCT is not effective in managing IAH under these trial conditions.
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