Urinary zinc excretion, diuretics, zinc deficiency and some side-effects of diuretics

Diuretics which principally act in the first portion of the distal convoluted tubule, such as the thiazides and chlorthalidone, significantly increase the urinary excretion of zinc. The potassium-retaining diuretic amiloride reduced urinary zinc excretion significantly. The hyperzincuria provoked by common distal tubular diuretics can cause zinc deficiency, especially when other aetiological factors such as alcoholism, renal insufficiency and pregnancy are also present. Zinc deficiency may be expressed clinically by hypogeusia, hyposmia, sexual impotence or delayed healing; the latter might be an important factor in cases of myocardial infarction.