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Use of Thiazides to Treat Hypertension and Advanced CKD

  • Hypertension (DS Geller and DL Cohen, Section Editors)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Hypertension is often difficult to control in patients with CKD as manifested by suboptimal control rates in this population. Use of thiazides in CKD patients has been limited as these agents are thought to be ineffective in reducing blood pressure in people with advanced CKD. This review summarizes recent studies impacting indications and safety of use of thiazide in patients with CKD and discusses the mechanism of how thiazides reduce blood pressure.

Recent Findings

Chlorthalidone reduces blood pressure compared to placebo in patients with advanced CKD, challenging the belief that thiazide diuretics lose efficacy at lower levels of GFR.

Summary

Recent clinical trial data indicate that thiazides are effective in patients with advanced kidney disease for blood pressure lowering. However, monitoring of electrolytes and kidney function is important to ensure patient safety when prescribing these agents in patients with CKD.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, NC, USA

    Gargi Sharma Priamvada & Raven Voora

  2. Sapthagiri Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India

    Divya Sharma Divyadarshini

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  1. Gargi Sharma Priamvada
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Correspondence to Raven Voora.

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Raven Voora is a paid speaker for Medtronic, Inc. The other authors declare that they have no conflict of interest.

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Priamvada, G.S., Divyadarshini, D.S. & Voora, R. Use of Thiazides to Treat Hypertension and Advanced CKD. Curr Cardiol Rep 24, 2131–2137 (2022). https://doi.org/10.1007/s11886-022-01817-y

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