Thiazide-induced subtle renal injury not observed in states of equivalent hypokalemia.

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Thiazide-induced subtle renal injury not observed in states of equivalent hypokalemia. Abstract Text:

S Reungjui,H Hu,W Mu,C A Roncal,B P Croker,J M Patel,T Nakagawa,T Srinivas,K Byer,J Simoni,D Wesson,V Sitprija,R J Johnson,S Reungjui,H Hu,W Mu,C A Roncal,B P Croker,J M Patel,T Nakagawa,T Srinivas,K Byer,J Simoni,D Wesson,V Sitprija,R J Johnson,S Reungjui,H Hu,W Mu,C A Roncal,B P Croker,J M Patel,T Nakagawa,T Srinivas,K Byer,J Simoni,D Wesson,V Sitprija,R J Johnson,

Hydrochlorothiazide (HCTZ) is used to manage hypertension and heart failure; however, its side effects include mild hypokalemia, metabolic abnormalities, and volume depletion, which might have deleterious effects on renal and endothelial function. We studied whether HCTZ cause renal injury and/or altered vasoreactivity and if these changes are hypokalemia-dependent. Rats were given a normal diet or a diet moderately low in potassium (K(+)) with or without HCTZ. Animals fed either a low K(+) diet alone or HCTZ developed mild hypokalemia. There was no significant difference in systolic blood pressure in the different treatment groups. All three groups with hypokalemia had mild proteinuria; low K(+)-HCTZ rats had reduced creatinine clearance. HCTZ-treated rats displayed hypomagnesemia, hypertriglyceridemia, hyperglycemia, insulin resistance, and hyperaldosteronism. No renal injury was observed in the groups without HCTZ; however, increased kidney weight, glomerular ischemia, medullary injury, and cortical oxidative stress were seen with HCTZ treatment. Endothelium-dependent vasorelaxation was reduced in all hypokalemic groups and correlated with reduced serum K(+), serum, and urine nitric oxide. Our results show that HCTZ is associated with greater renal injury for the same degree of hypokalemia as the low K(+) diet, suggesting that factors such as chronic ischemia and hyperaldosteronism due to volume depletion may be responsible agents. We also found impaired endothelium-dependent vasorelaxation was linked to mild hypokalemia.Kidney International (2007) 72, 1483-1492; doi:10.1038/sj.ki.5002564; published online 10 October 2007.

Thiazide-induced subtle renal injury not observed in states of equivalent hypokalemia. Publishing Authors By Initials

S Reungjui,H Hu,W Mu,CA Roncal,BP Croker,JM Patel,T Nakagawa,T Srinivas,K Byer,J Simoni,D Wesson,V Sitprija,RJ Johnson,S Reungjui,H Hu,W Mu,CA Roncal,BP Croker,JM Patel,T Nakagawa,T Srinivas,K Byer,J Simoni,D Wesson,V Sitprija,RJ Johnson,S Reungjui,H Hu,W Mu,CA Roncal,BP Croker,JM Patel,T Nakagawa,T Srinivas,K Byer,J Simoni,D Wesson,V Sitprija,RJ Johnson,

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Thiazide-induced subtle renal injury not observed in states of equivalent hypokalemia. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Kidney international

VOLUME: 72

Page Numbers: 1483-92

Journal Abbreviation: Kidney Int.

ISSN: 0085-2538

DAY: 10

MONTH: 10

YEAR: 2007

Thiazide-induced subtle renal injury not observed in states of equivalent hypokalemia. Information

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LANGUAGE: eng

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AFFILIATION: 1Division of Nephrology, Hypertension and Transplantation, Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA.

Country: United States

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MEDLINETA: Kidney Int

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