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Amiloride-induced hyponatremia

L Tarssanen, M Huikko, M Rossi

    Acta Medica Scandinavica
    |January 1, 1980
    PubMed
    Summary
    This summary is machine-generated.

    We identified a new syndrome, amiloride hyponatremia, in elderly women taking amiloride and hydrochlorothiazide. This condition can be managed by switching to potassium supplementation instead of amiloride.

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    Area of Science:

    • Nephrology
    • Clinical Pharmacology
    • Geriatrics

    Background:

    • Diuretic therapy is common for cardiovascular diseases.
    • Hyponatremia can occur as a side effect of diuretics, particularly in the elderly.
    • Distinguishing between different types of diuretic-induced hyponatremia is crucial for appropriate management.

    Observation:

    • Three elderly female patients developed hyponatremia while on combination therapy with amiloride and hydrochlorothiazide.
    • These patients required continued diuretic treatment and tolerated hydrochlorothiazide with potassium chloride supplementation.
    • The observed hyponatremia was distinct from other known diuretic-induced hyponatremia syndromes.

    Findings:

    • A novel syndrome, termed "amiloride hyponatremia", is proposed, characterized by hyponatremia during amiloride plus hydrochlorothiazide therapy.

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  • This syndrome appears to result from a direct effect of the amiloride-hydrochlorothiazide combination on the distal nephrons.
  • Treatment involves replacing amiloride with potassium supplementation, allowing continued thiazide therapy.

    • Implications:

    • The findings highlight the need for caution when prescribing amiloride plus hydrochlorothiazide to elderly patients.
    • Clinicians should consider amiloride hyponatremia in elderly patients presenting with vague symptoms or central nervous system disturbances.
    • This research suggests a specific mechanism for diuretic-induced hyponatremia and offers a targeted therapeutic approach.