Severe Hyponatremia Associated with Thiazide Diuretic Use

Abstract Background Thiazide diuretics are commonly used as first-line antihypertensive agents. Hyponatremia is a reported, though uncommon, complication of thiazide use. Although the exact mechanism of thiazide-induced hyponatremia (TIH) is unclear, it can be a significant cause of morbidity and mo...

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Bibliographic Details
Published in:The Journal of emergency medicine 2015-03, Vol.48 (3), p.305-309
Main Authors: Sardar, Gurkiran K., MD, MPH, Eilbert, Wesley P., MD
Format: Article
Language:English
Subjects:
Aged
diuretics
Emergency
Humans
Hydrochlorothiazide - adverse effects
hyponatremia
Hyponatremia - chemically induced
hyponatremia management
Male
Sodium Chloride Symporter Inhibitors - adverse effects
thiazide-induced hyponatremia
thiazides
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Summary:Abstract Background Thiazide diuretics are commonly used as first-line antihypertensive agents. Hyponatremia is a reported, though uncommon, complication of thiazide use. Although the exact mechanism of thiazide-induced hyponatremia (TIH) is unclear, it can be a significant cause of morbidity and mortality. Case Report We report a 69-year-old man with generalized weakness beginning 2 weeks after starting hydrochlorothiazide (HCTZ). Evaluation revealed a serum sodium level of 120 mmol/L. The patient was admitted and successfully treated with free water restriction and discontinuation of the HCTZ. Why should an emergency physician be aware of this? Hyponatremia is an uncommon complication of thiazide diuretic use, which frequently presents with nonspecific symptoms. Identification of TIH is crucial to prevent its potentially life-threatening complications.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2014.09.054