How Do Diuretics Affect The Kidneys
4.3/5Diureticscausekidneyscause
In this regard, do Diuretics cause kidney damage?
Diuretics. Water pills like hydrochlorothiazide and furosemide, used for high blood pressure and edema, can cause dehydration and can also lead to swelling and inflammation of the kidneys. The following tips can help prevent the risk of kidney damage.
One may also ask, do diuretics improve kidney function? Observational studies with small sample size and short duration have shown that diuretics decrease blood pressure and improve edema in CKD patients but their use, particularly at higher doses, is associated with rise in serum creatinine and several metabolic complications .
Similarly, it is asked, what diuretics are safe for kidneys?
Description of the intervention
Chronic Kidney Disease Fluid Overload And Diuretics: A Complicated Triangle
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* E-mail:
Affiliations Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11800, Malaysia, Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, 16150, Kelantan, Malaysia
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Affiliation Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11800, Malaysia
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* E-mail:
Affiliation Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, 16150, Kelantan, Malaysia
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Affiliation Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11800, Malaysia
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Affiliations Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, 11800, Malaysia, Chronic Kidney Disease Resource Centre, School of Medical Sciences, Health Campus, University Sains Malaysia, Kubang Kerain, 16150, Kelantan, Malaysia
Can Metoprolol Cause Muscle Pain
4.7/5muscle cramps
Beta blockers may cause diarrhea, stomach cramps, nausea and vomiting. Rash, blurred vision, muscle cramps, and fatigue have also been reported. Beta blockers may cause hypoglycemia or hyperglycemia and mask the symptoms of hypoglycemia in diabetic patients. Beta blockers may cause shortness of breath in asthmatics.
One may also ask, what are the side effects of metoprolol? Common side effects of metoprolol include:
- Dizziness or lightheadedness.
- Gas or bloating.
Subsequently, one may also ask, can metoprolol cause muscle and joint pain?
Lopressor HCT Nervous System: Dizziness or vertigo, drowsiness or somnolence, and headache have each occurred in about 10 in 100 patients. Nightmare has occurred in 1 in 100 patients. Musculoskeletal: Muscle pain has occurred in 1 in 100 patients.
Can blood pressure meds cause muscle pain?
Medications that can cause muscle cramps include: Furosemide , hydrochlorothiazide , and other diuretics that remove fluid from the body. Donepezil , used to treat Alzheimers disease. Nifedipine , a treatment for angina and high blood pressure.
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What Diuretics Help Treat
The most common condition treated with diuretics is high blood pressure. The drugs reduce the amount of fluid in your blood vessels, and this helps lower your blood pressure.
Other conditions are also treated with diuretics. Congestive heart failure, for instance, keeps your heart from pumping blood effectively throughout your body. This leads to a buildup of fluids in your body, which is called edema. Diuretics can help reduce this fluid buildup.
The three types of diuretic medications are called thiazide, loop, and potassium-sparing diuretics. All of them make your body excrete more fluids as urine.
Kidney Impairment Can Be Costly
Although renal impairment is often reversible if the offending drug is discontinued, the condition can be costly and may require multiple interventions, including hospitalization, Dr. Naughton explained. To help you avoid getting to that point, we learned about medications that commonly cause kidney damage from Rebekah Krupski, PharmD, RPh, pharmacy resident at the Cleveland Clinic and clinical instructor of pharmacy practice at Northeast Ohio Medical University.
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Changes In Kidney Function During Intercurrent Illness
Regardless of whether patients are treated with RAAS inhibitors, changes in renal function are common during acute intercurrent illness the incidence of AKI is between 7% and 18% of hospitalised patients. AKI is a powerful risk marker for poor outcome and is strongly associated with an increase in the risk of subsequent admission for heart failure. Renal function often does not to return to baseline level in survivors of AKI, especially in those with pre-existing CKD.
The incidence of AKI as defined by hospital coding is rising rapidly, which may reflect a genuine increase or simply greater awareness. Conditions associated with the development of AKI are also common indications for RAAS inhibitors and thus AKI in association with RAAS blockade is a common clinical scenario. However, it is not clear that ACEI/ARB therapy alone is associated with a substantially increased risk of AKI.
In patients on a RAAS inhibitor, intercurrent illness commonly causes AKI, but there is no evidence that stopping the RAAS inhibitor is beneficial.
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If a patient with HFrEF develops hyperkalaemia :
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Potassium 5.5mmol/L, monitor closely, medication review and consider suspending RAAS inhibitor.
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Potassium 6.0mmol/L, stop RAAS inhibitor.
If the patient with HFrEF has a rise in creatinine during intercurrent illness:
Stop any other medication that may worsen renal function, including diuretic if clinically appropriate.
If by 30%,RAAS inhibitor should be stopped.
Temporarily Stopping Taking Medicine To Prevent Acute Kidney Injury When Unwell: Risks And Benefits
Kidney function can decrease suddenly when someone becomes unwell, for example with an infection or diarrhoea and vomiting. The chance of this happening is greater when the person is elderly, has other medical problems or is taking certain medicine.
This drop in kidney function is called acute kidney injury . An affected person is more likely to be admitted to hospital and people in hospital with acute kidney injury spend longer there than those without AKI. One in four patients admitted to hospital with acute kidney injury do not survive. Those that do are often left with long term kidney damage.
Some experts suggest that advising patients to stop taking certain medicines during illnesses known as sick day rules could reduce the chances of acute kidney injury. These medicines include water tablets , and a type of blood pressure tablets called renin angiotensin aldosterone system inhibitors.
However the risks of not taking these medications have not been fully explored, and the relationship between these medications and AKI in a real world setting is not clear.
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What You Can Do
If you have side effects that bother you while taking diuretics, talk to your doctor. They may prescribe a different medication or combination of medications to help reduce your side effects.
Whether or not you have side effects, dont stop taking your diuretic without first talking to your doctor.
Diuretics are generally safe, but there are some risks if you have other medical conditions or take certain medications.
Diuretic Mechanism And Uses
Water pills, also known as diuretics, work by affecting the way the kidneys filter the blood. Some of them block the ability of the kidneys to reabsorb sodium and/or potassium, which also pulls extra water into the urine. Others increase the rate at which urine flows through the kidneys. Regardless of their mechanism, water pills increase the amount of water lost through the urine and often are used to treat high blood pressure, kidney disease and congestive heart failure, the Texas Heart Institute explains. Because they eliminate water from the body, they may also cause short-term weight loss.
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The Interaction Between Diuretics And Kidney Function
Now that you know a little more about how the kidneys function and how your blood pressure is regulated, we can focus more on what these water pills diuretics can do to influence these measurements.
Diuretics help reduce excess water within the body to help reduce the amount of fluid within, and pressure on, your blood vessels. This causes blood pressure to be reduced.
There are a few different types of diuretics that doctors can choose from when it comes to trying to lower your blood pressure. The main difference between these medications is the specific part of the kidney that is affected when these medications are administered. The most common classes that we typically use would be loop diuretics like furosemide , potassium-sparing diuretics like aldosterone, and thiazides. They all do a good job controlling your blood pressure but in most patients, we will typically start with a loop diuretic and then build up from there if necessary, if the patient’s blood pressure is still high.
As you can imagine, medications are substances that are not natural and are designed to be a temporary solution to a problem like hypertension. When chronic conditions like diabetes and hypertension start to influence the function of the kidneys more dramatically, it will become harder and harder for a patient to be able to manage their blood pressure through dieting alone and medications will be started.
Hiv Medications And Antiviral Drugs
Certain antiviral HIV medications are linked to long-term kidney damage and can increase your risk for kidney disease. Viread and Reyataz have both been shown to cause AKI.
Antivirals such as acyclovir and Valtrex , may lead to kidney swelling and inflammation and can also produce crystals deposits that can lead to obstruction of the ureters.
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Can Diuretics Cause Aki
causeAKIdiureticsdiureticsAKI
. Furthermore, can Diuretics cause acute renal failure?
Of 131 diuretics associated AKI, 36 cases were caused by diuretics only, 39 cases were caused by the combination of diuretics and other drugs like antibiotics, contrast media, ACEI or NSAIDs, and 56 cases had other AKI risk factors such as operation, infection, acute heart failure or hepatorenal
Additionally, are diuretics harmful in the management of acute kidney injury? SUMMARY: Diuretics are ineffective and even detrimental in the prevention and treatment of AKI, and neither shorten the duration of AKI, nor reduce the need for renal replacement therapy. Diuretics have an important role in volume management in AKI, but they are not recommended for the prevention of AKI.
Keeping this in view, can furosemide cause acute kidney injury?
Bove and his colleagues performed an excellent systematic review and reported that furosemide exhibited a neutral effect in acute kidney injury treatment 1.14 95% CI 0.75 to 1.72). Despite being well designed, several limitations should be noted.
Do diuretics harm kidneys?
Diuretics. Water pills like hydrochlorothiazide and furosemide, used for high blood pressure and edema, can cause dehydration and can also lead to swelling and inflammation of the kidneys. The following tips can help prevent the risk of kidney damage.
Drugs You May Need To Avoid Or Adjust If You Have Kidney Disease
Medications save and improve lives, but it can be easy to overlook their risks and side effects, especially if you dont think they apply to you. Twenty-six million Americans have chronic kidney disease and most dont know it.
If you dont know how well your kidneys are working, you may not realize that certain medications could be damaging your kidneys and other parts of your body. Both prescription and over-the-counter medications are filtered by the kidneys. This means that your kidneys degrade and remove medications from the body.
When your kidneys arent working properly, medications can build up and cause you harm. Its important to get your kidneys checked and to work with your doctor to make any adjustments to your medication regimen, such as dosing changes or substitutions. This will help prevent any negative effects from the medication, including further kidney damage.
You can determine your level of kidney function with a blood test for serum creatinine to calculate an eGFR measurement. An eGFR estimates how well your kidneys are filtering wastes from the blood.
Here are 5 common types of prescription and over-the-counter medications may need to be adjusted or replaced if you have kidney damage.
COVID-19 patients can become kidney patients.
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What Exactly Is Kidney Failure
To start off with, it may be a good idea to address what exactly a term like kidney failure actually means. When your doctor says that you have kidney failure or chronic kidney disease, you may think the situation is much more serious than it actually is, since you know that you require at least one semi-functional kidney to be able to live.
As a person ages, the kidneys will start to become less and less effective at filtering out toxins and regulating the water-electrolyte balance within the body. As a result, parameters that are used to measure the function of the kidneys like creatinine and GFR will begin to change.
When a patient has a comorbidity , on the other hand, kidney damage is likely to accelerate and this is when you may need to start making appointments at your local nephrologist. Some of the most common conditions that significantly damage kidney function would be type 2 diabetes, alcohol consumption, and smoking.
Medications That Can Harm The Kidneys
No matter what kind of medicine you take, whether OTC or prescription, it is destined to take a trip through your kidneys. Taking a drug the wrong way or in excessive amounts can damage these vital, bean-shaped organs and lead to serious complications. In the worst-case scenario, it could necessitate a kidney transplant.
Compared with 30 years ago, patients todayhave a higher incidence of diabetes and cardiovascular disease, take multiple medications, and are exposed to more diagnostic and therapeutic procedures with the potential to harm kidney function, according to Cynthia A. Naughton, PharmD, senior associate dean and associate professor in the department of pharmacy practice at North Dakota State University. All of these factors are associated with an elevated risk of kidney damage.
An estimated 20% of cases of acute kidney failure are due to medications. The technical term for this scenario is nephrotoxicity, which is growing more common as the aging population grows, along with rates of various diseases.
The kidneys get rid of waste and extra fluid in the body by filtering the blood to produce urine. They also keep electrolyte levels balanced and make hormones that influence blood pressure, bone strength and the production of red blood cells. When something interferes with the kidneys, they cant do their job, so these functions can slow down or stop altogether.
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Will Diuretics Cause Constipation
Yes, diuretics can cause constipation if you dont drink enough fluids.
A note from Cleveland Clinic
Diuretics can help you manage your high blood pressure and other conditions, but you need to take them the right way. Keep taking the same dose on schedule unless your provider tells you to change what youre doing. If the diuretic youre taking is giving you side effects, ask your provider if you can switch to a different diuretic.
Last reviewed by a Cleveland Clinic medical professional on 10/01/2021.
References
What Do Diuretics Do To The Kidneys
Diureticswater pillskidneysThere are three types of diuretics:
- Loop-acting diuretics, such as Bumex®, Demadex®, Edecrin® or Lasix®.
- Potassium-sparing diuretics, such as Aldactone®, Dyrenium® or Midamor®.
- Thiazide diuretics, such as Aquatensen®, Diucardin® or Trichlorex®.
The 8 Best Natural Diuretics to Eat or Drink
- Dandelion Extract. Dandelion extract, also known as Taraxacum officinale or lion’s tooth, is a popular herbal supplement often taken for its diuretic effects .
- Horsetail.
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Effects Of Diuretics On Gfr In Chf
Diuretic treatment does not prevent or ameliorate AKI. Although higher diuretic dose in CHF is associated with worse outcome, the reason is that higher doses of diuretics are a marker of more severe heart failure. Intravenous diuretics cause increased activity of the sympathetic nervous system and the RAAS, resulting in a fall in GFR, but diuretic-induced decongestion can improve GFR by reducing renal venous pressure.
Pitfalls And Potential Strategies During Treatment
Treating and solving congestion are among the principal goals of AHF management. Persistence of congestion and poor response to diuretic treatment are associated with increased risk of mortality and threefold higher rate of re-hospitalization . Because higher-dose regimens have been related to adverse outcome, relevant questions remain about the optimal use of diuretics to obtain efficient decongestion. A post-hoc analysis from DOSE and Cardiorenal Rescue Study in Acute Decompensated HF highlighted that higher levels of plasma renin activity were associated with lower blood pressure, azotemia, and hyponatremia in more advanced HF . A report by Testani et al. showed that BUN/creatinine ratio but not creatinine increase alone was associated with early adverse events . These studies suggest that neurohormonal activation and plasma volume contraction due to poor plasma refill are major determinants of short-term complications, including hypotension, AKI, and hyponatremia .
Fig. 2
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Loop Diuretics Decongestion And Acute Kidney Injury
Baseline renal function and the dynamic change in serum creatinine are related to short- and longer-term outcomes. A recent observational study showed that creatinine change during hospitalization was independently associated with a higher risk of 1-year mortality. However, in patients with normal or mildly impaired renal function, creatinine changes were not significantly associated with mortality. Interestingly, in this subgroup of patients, a decrease in Cr was associated with worse outcomes. Perhaps a transient deterioration of renal function is required to relieve congestion and improve global symptom assessment. Thus, the intricate cardio-renal axis relation is much more confused by the diuretic administration that could potentially amplify deleterious effects at the kidney level. Studies in this field revealed contrasting results: some authors did not observe a poor prognosis during treatment in patients who experienced worsening renal function . Others believe that impaired renal function during treatment is only the consequence of aggressive fluid loss and decongestion. Aggressive decongestion associated with plasma hemoconcentration is associated with significant mortality reduction at 6 months, although an increase in creatinine was observed .
Drug Dosing Adjustments In Patients With Chronic Kidney Disease
MYRNA Y. MUNAR, PHARMD, BCPS, and HARLEEN SINGH, PharmD, Oregon State University College of Pharmacy, Portland, Oregon
Am Fam Physician. 2007 May 15 75:1487-1496.
This article exemplifies the AAFP 2007 Annual Clinical Focus on management of chronic illness.
Chronic kidney disease affects renal drug elimination and other pharmacokinetic processes involved in drug disposition . Drug dosing errors are common in patients with renal impairment and can cause adverse effects and poor outcomes. Dosages of drugs cleared renally should be adjusted according to creatinine clearance or glomerular filtration rate and should be calculated using online or electronic calculators. Recommended methods for maintenance dosing adjustments are dose reductions, lengthening the dosing interval, or both. Physicians should be familiar with commonly used medications that require dosage adjustments. Resources are available to assist in dosing decisions for patients with chronic kidney disease.
The National Kidney Foundation Kidney Disease Outcomes Quality Initiative definition of chronic kidney disease is the presence of kidney damage or a reduction in the glomerular filtration rate for three months or longer. The K/DOQI chronic kidney disease staging system is based on GFR.1
SORT: KEY RECOMMENDATIONS FOR PRACTICE
SORT: KEY RECOMMENDATIONS FOR PRACTICE
National Kidney Foundation K/DOQI Staging System for Chronic Kidney Disease
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Publisher: American College of Physicians |
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